Healthcare Provider Details

I. General information

NPI: 1578351086
Provider Name (Legal Business Name): NATASHA RENEE CHILDRESS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 AFRICA RD STE 200
WESTERVILLE OH
43082-9830
US

IV. Provider business mailing address

625 AFRICA RD STE 200
WESTERVILLE OH
43082-9830
US

V. Phone/Fax

Practice location:
  • Phone: 614-891-8080
  • Fax: 614-891-7078
Mailing address:
  • Phone: 614-891-8080
  • Fax: 614-891-7078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0039149
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: