Individual
AUDREY J BAKANAUSKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
452 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-7677
(614) 293-5614
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-7677
(614) 293-5614
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
001638
CT
363L00000X
Nurse Practitioner
Primary
APRN.CNP.10777
OH
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.10777
OH
363LF0000X
Family Nurse Practitioner
APRN.CNP.10777
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004197639
—
CT
Enumeration date
08/12/2005
Last updated
05/28/2026
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