Basic Information
| Provider Information | |||||||||
| NPI: | 1457449860 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOMBROSKI | ||||||||
| FirstName: | CHRISTINE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 OLENTANGY RIVER RD | ||||||||
| Address2: | SUITE 490 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432143437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144591000 | ||||||||
| FaxNumber: | 6144591382 | ||||||||
| Practice Location | |||||||||
| Address1: | 3600 OLENTANGY RIVER RD | ||||||||
| Address2: | SUITE 490 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432143437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144591000 | ||||||||
| FaxNumber: | 6144591382 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 08/29/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN.CNP.00723 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LX0001X | COA00723NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | DOM10427 | 01 | OH | BOARD CERTIFICATION | OTHER |