Individual
CLISTA DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
625 W WATERLOO ST, STE 210B, CANAL WINCHESTER, OH 43110
(614) 955-3430
(614) 533-0465
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.18805
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0158584
—
OH
Enumeration date
02/16/2016
Last updated
03/25/2026
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