Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 16817 | OH |
NPI | 1003196965 |
---|---|
Provider Name | Megan Lottes |
First Address | Columbus, OH 43201-1113 |
Second Address | Columbus, OH 43201-1113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2011 |
Last Update Date | 19/12/2014 |