Provider Demographics
NPI:1073622841
Name:COLVIN, ANDREW M (CNP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:M
Last Name:COLVIN
Suffix:
Gender:M
Credentials:CNP
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Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-6567
Mailing Address - Fax:614-366-4545
Practice Address - Street 1:452 W 10TH AVE
Practice Address - Street 2:RHH 1255
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-5502
Practice Address - Fax:614-293-4726
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2018-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.08388363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2638953Medicaid
Q59442Medicare UPIN
OH2638953Medicaid