Provider Demographics
NPI:1649782095
Name:NORTHWEST SURGICAL ASSISTING
Entity type:Organization
Organization Name:NORTHWEST SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:KELCH
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:614-325-4876
Mailing Address - Street 1:1864 STOCKWELL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-7370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1864 STOCKWELL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-7370
Practice Address - Country:US
Practice Address - Phone:614-325-4876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty