Healthcare Provider Details
I. General information
NPI: 1497844856
Provider Name (Legal Business Name): NATALIE WYSS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
605 CRESCENT PL
GAHANNA OH
43230-3086
US
IV. Provider business mailing address
340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US
V. Phone/Fax
- Phone: 614-545-7900
- Fax: 614-545-7901
- Phone: 614-545-7900
- Fax: 614-545-7901
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 50.002528RX |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: