Healthcare Provider Details

I. General information

NPI: 1770206724
Provider Name (Legal Business Name): LAUREN ZYLKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 12/20/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 2023
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE, 6015
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4371
  • Fax: 513-636-7657
Mailing address:
  • Phone: 513-636-0800
  • Fax: 513-803-0823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0032377
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: