Healthcare Provider Details

I. General information

NPI: 1003837352
Provider Name (Legal Business Name): AMY E FATHMAN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ALTAIR PKWY STE 3100
WESTERVILLE OH
43082-7653
US

IV. Provider business mailing address

9855 WASHINGTON TRACE RD
CALIFORNIA KY
41007-8507
US

V. Phone/Fax

Practice location:
  • Phone: 614-360-9995
  • Fax: 614-745-0165
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3003600
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: