Individual
MS. DESIREE ETTALEE VAN DYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3535 OLENTANGY RIVER RD, COLUMBUS, OH 43214-3998
(614) 566-5000
Mailing address
3535 OLENTANGY RIVER RD STE 2010, COLUMBUS, OH 43214-3998
(614) 566-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003418RX
OH
363A00000X
Physician Assistant
PA3049
KY
363A00000X
Physician Assistant
TC224
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300067576
—
IN
05
—
7100835360
—
KY
Enumeration date
10/20/2011
Last updated
10/02/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us