Provider Demographics
NPI:1265182596
Name:GIANGARDELLA, NATHAN
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:GIANGARDELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-814-8490
Mailing Address - Fax:614-814-8520
Practice Address - Street 1:6100 N HAMILTON RD FL 4
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2062
Practice Address - Country:US
Practice Address - Phone:614-814-8490
Practice Address - Fax:614-814-8520
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.485291163WR0400X
OHAPRN.CNP.0032370363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation