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General NPI Number Information
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NPI Number | 1497730063
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Entity Type | Individual
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Provider Name | KNIAKA R BETHEL N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 4885 OLENTANGY RIVER RD STE 1-10
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City | COLUMBUS
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State | OH
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Zip | 43214
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Country | US
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Telephone | 614-268-6555
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Fax | 614-457-5713
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Provider Business Mailing Address
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Address Line | 4885 OLENTANGY RIVER RD STE 1-10
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City | COLUMBUS
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State | OH
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Zip | 43214-1953
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Country | US
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Telephone | 614-268-6555
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Fax | 614-457-5713
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.08435
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License Number State | OH
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