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NPI 1053831800

NPI 1053831800 : ANDREW THOMAS WASSON FNP-C : COLUMBUS, OH

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General NPI Number Information
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    NPI Number           |    1053831800
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW THOMAS WASSON FNP-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/22/2017
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    Last Update Date     |    01/25/2022
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Provider Practice Location Address
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    Address Line         |    3535 OLENTANGY RIVER RD 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43214-3908
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    Country              |    US
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    Telephone            |    614-566-5000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5450 FRANTZ RD STE 360 
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    City                 |    DUBLIN
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    State                |    OH
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    Zip                  |    43016-4141
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163WM0705X
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    Taxonomy Name        |    Medical-Surgical Registered Nurse
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    License Number       |    RN.360887
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    APRN.CNP.020941
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    License Number State |    OH
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