Provider Demographics
NPI:1568961795
Name:SIEKMANN, KAITLYN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:
Last Name:SIEKMANN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3683 MEAD DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7595
Mailing Address - Country:US
Mailing Address - Phone:304-641-0490
Mailing Address - Fax:
Practice Address - Street 1:OHIOHEALTH PHYSICIAN GROUP, INC.
Practice Address - Street 2:285 E. STATE ST. STE. 430
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215
Practice Address - Country:US
Practice Address - Phone:614-533-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022205363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner