Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.020687 | OH |
N | 363LF0000X | Nurse Practitioner - Family Medicine | APRN81885-FNP-BC | WV |
NPI | 1003350752 |
---|---|
Provider Name | Lauren Rae Matheny |
First Address | Dublin, OH 43017-0727 |
Second Address | Columbus, OH 43221-2127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2016 |
Last Update Date | 14/12/2021 |