Healthcare Provider Details

I. General information

NPI: 1255633137
Provider Name (Legal Business Name): IAN-VI NAGA MAPP WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2010
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 E STATE ST STE 200
COLUMBUS OH
43215-0109
US

IV. Provider business mailing address

827 CHAPELGATE DR
FAIRBORN OH
45324-4495
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax: 833-775-1861
Mailing address:
  • Phone: 888-731-8994
  • Fax: 833-775-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number9236659
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.0030388
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number9236659
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0030388
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN9236659
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: