MEDICARE: NATASHA RENEE CHILDRESS APRN, FNP-C

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
1	163W00000X	Registered Nurse	RN.391397	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.0039149	OH

General Provider Information

NPI Number	:	1578351086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA RENEE CHILDRESS APRN, FNP-C

Provider Business Mailing Address
First Line	:	3897 CHICKORY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-1010
Country	:	US
Telephone Number	:	614-307-1399
Fax Number	:

Provider Business Practice Location Address
First Line	:	3897 CHICKORY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-1010
Country	:	US
Telephone Number	:	614-307-1399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2025
Last Update Date	:	04/26/2025

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