Basic Information
Provider Information
NPI: 1962739029
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAWYER
FirstName: CHRISTINA
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: C.N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 ACKERMAN RD
Address2: SUITE 570
City: COLUMBUS
State: OH
PostalCode: 432021559
CountryCode: US
TelephoneNumber: 6142934925
FaxNumber:  
Practice Location
Address1: 2050 KENNY RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432213502
CountryCode: US
TelephoneNumber: 6142934925
FaxNumber: 6142935503
Other Information
ProviderEnumerationDate: 11/11/2009
LastUpdateDate: 11/10/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X773795TXN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363LA2100X068878-23NHN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363L00000XCOA18079NPOHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

ID Information
IDTypeStateIssuerDescription
PENDING05OH MEDICAID
20937670105TX MEDICAID


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