Provider Demographics
NPI:1235855842
Name:KRASA, NANCY R (PHD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:R
Last Name:KRASA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 N PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1438
Mailing Address - Country:US
Mailing Address - Phone:614-257-1946
Mailing Address - Fax:614-252-7862
Practice Address - Street 1:268 N PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-1438
Practice Address - Country:US
Practice Address - Phone:614-257-1946
Practice Address - Fax:614-252-7862
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3699103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist