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Specialty details in registry · Reynoldsburg, OH

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At a glance

6496 Portsmouth Dr, Reynoldsburg, OH 43068-1948

NPPES record updated Feb 5, 2013. Public records can lag behind changes at a practice.

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Practice location

6496 Portsmouth Dr
Reynoldsburg, OH 43068-1948

Professional details: NPI, taxonomy & registry record

NPI1154660579

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 251B00000X
Enumeration date: Feb 5, 2013
Record updated: Feb 5, 2013

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251B00000X · Primary

License reported: RN340618 MA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

6496 Portsmouth Dr
Reynoldsburg, OH 43068-1948

Phone: (614) 986-9374
Fax: (614) 986-9374

Mailing address

6496 PORTSMOUTH DR

REYNOLDSBURG, OH 430681948

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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