MEDICARE: LAUREN ELIZABETH MALLORY CNP

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	363L00000X	Nurse Practitioner	0042164	OH

General Provider Information

NPI Number	:	1609327220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELIZABETH MALLORY CNP

Provider Business Mailing Address
First Line	:	850 SOUTHMEADOW CIR UNIT 101
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-6112
Country	:	US
Telephone Number	:	513-295-9870
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 SOUTHMEADOW CIR UNIT 101
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-6112
Country	:	US
Telephone Number	:	513-295-9870
Fax Number	:

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

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	06/02/2026

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