Healthcare Provider Details

I. General information

NPI: 1255069993
Provider Name (Legal Business Name): MEREDITH MARESCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 POLARIS PKWY STE 250
WESTERVILLE OH
43082-8074
US

IV. Provider business mailing address

110 POLARIS PKWY STE 250
WESTERVILLE OH
43082-8074
US

V. Phone/Fax

Practice location:
  • Phone: 614-865-4800
  • Fax: 614-865-4900
Mailing address:
  • Phone: 614-865-4800
  • Fax: 614-865-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0031528
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: