MEDICARE: LORRIE HERDMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1043187883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRIE HERDMAN

Provider Business Mailing Address
First Line	:	140 E TOWN ST STE 1450
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-6601
Country	:	US
Telephone Number	:	614-639-6590
Fax Number	:

Provider Business Practice Location Address
First Line	:	4236 E BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1279
Country	:	US
Telephone Number	:	380-201-1315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2025
Last Update Date	:	10/17/2025

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Directions to “ LORRIE HERDMAN ” Practice Location

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