Healthcare Provider Details

I. General information

NPI: 1992219265
Provider Name (Legal Business Name): SARAH LEVINSON KUKURA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2017
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-2000
  • Fax:
Mailing address:
  • Phone: 614-722-4200
  • Fax: 614-722-4565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.019668
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: