Healthcare Provider Details

I. General information

NPI: 1447280151
Provider Name (Legal Business Name): CHRISTINE M PROK CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 WEST CAMPUS OVAL CENTRAL OHIO SURGICAL INSTITUTE
NEW ALBANY OH
43054
US

IV. Provider business mailing address

8691 FILIZ LN
POWELL OH
43065-8025
US

V. Phone/Fax

Practice location:
  • Phone: 614-413-2233
  • Fax: 614-413-2234
Mailing address:
  • Phone: 740-360-5728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.05478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: