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NPI Code Detail

MEDICARE: MRS. NIKITA MARIE ANDERSON CNP

MEDICARE: MRS. NIKITA MARIE ANDERSON CNP
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.0026937OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760002695
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NIKITA MARIE ANDERSON CNP
Provider Business Mailing Address
First Line : 5450 FRANTZ RD STE 360
Second Line :
City : DUBLIN
State : OH
Zip : 43016-4141
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2222 WELCOME PL
Second Line :
City : COLUMBUS
State : OH
Zip : 43209-7813
Country : US
Telephone Number : 614-338-8833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2020
Last Update Date : 01/25/2022

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