Provider Demographics
NPI:1881279628
Name:DODSON, KIRSTEN (FNP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:GLASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4093 STOCKADE PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1535
Mailing Address - Country:US
Mailing Address - Phone:614-284-5290
Mailing Address - Fax:
Practice Address - Street 1:1085 POLARIS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2004
Practice Address - Country:US
Practice Address - Phone:614-505-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028542364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health