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NPI Code Detail

MEDICARE: CHAD DOUGLAS WITTEKIND FNP-BC

MEDICARE: CHAD DOUGLAS WITTEKIND FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN.CNP.024755OH

General Provider Information

NPI Number : 1538727060
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAD DOUGLAS WITTEKIND FNP-BC
Provider Business Mailing Address
First Line : 949 BRIARHILL DR
Second Line :
City : NEWARK
State : OH
Zip : 43055-2267
Country : US
Telephone Number : 740-366-2976
Fax Number :
Provider Business Practice Location Address
First Line : 2260 MORSE RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-5858
Country : US
Telephone Number : 614-702-7899
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2019
Last Update Date : 02/05/2026

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