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Individual

RUSSELL CLAY LIGHTFOOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4200
(614) 722-4203
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
(614) 722-4380

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.17440
OH
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.17440
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0142842
OH
Enumeration date
07/09/2015
Last updated
04/16/2026
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