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NPI Code Detail

MEDICARE: MRS. KELLEY LYNN VAN ATTA CNP

MEDICARE: MRS. KELLEY LYNN VAN ATTA 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
1363LA2100XAcute Care Nurse PractitionerAPRN.CNP.0027390OH

General Provider Information

NPI Number : 1942812193
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLEY LYNN VAN ATTA CNP
Provider Business Mailing Address
First Line : 1900 S MAIN ST
Second Line :
City : FINDLAY
State : OH
Zip : 45840-1214
Country : US
Telephone Number : 419-423-5221
Fax Number : 419-423-5143
Provider Business Practice Location Address
First Line : 1900 S MAIN ST
Second Line :
City : FINDLAY
State : OH
Zip : 45840-1216
Country : US
Telephone Number : 419-423-5221
Fax Number : 419-423-5143
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2020
Last Update Date : 08/19/2020

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