Provider Demographics
NPI:1295298792
Name:DINDIOK, FAUSTINA DATAMIT (BSN,RN)
Entity type:Individual
Prefix:
First Name:FAUSTINA
Middle Name:DATAMIT
Last Name:DINDIOK
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 COURTRIGHT DR E
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1579
Mailing Address - Country:US
Mailing Address - Phone:614-218-2105
Mailing Address - Fax:
Practice Address - Street 1:4226 SESTOS DR
Practice Address - Street 2:COLUMBUS
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207
Practice Address - Country:US
Practice Address - Phone:614-218-2105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033956363LP0808X
OHRN.407857163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse