MEDICARE: CHRISTINA S GAST I NP

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.0027979	OH

General Provider Information

NPI Number	:	1942891825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA S GAST I NP

Provider Business Mailing Address
First Line	:	PO BOX 449
Second Line	:
City	:	MARIETTA
State	:	OH
Zip	:	45750-0449
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 LEE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-2557
Country	:	US
Telephone Number	:	216-350-1000
Fax Number	:

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

Provider Enumeration Date	:	02/02/2021
Last Update Date	:	01/18/2024

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