Healthcare Provider Details

I. General information

NPI: 1023361110
Provider Name (Legal Business Name): CHRISTOPHER SCOTT BEGAN CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2012
Last Update Date: 10/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5783 DARROW RD
HUDSON OH
44236-3866
US

IV. Provider business mailing address

5032 LAKE VIEW DR
PENINSULA OH
44264-9806
US

V. Phone/Fax

Practice location:
  • Phone: 330-630-0605
  • Fax:
Mailing address:
  • Phone: 330-760-5552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA 10457-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: