Healthcare Provider Details

I. General information

NPI: 1760865612
Provider Name (Legal Business Name): LYNNE LAURENCE BROPHY RN-BC, MSN, AOCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. LYNNE LAURENCE RUSSELL

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

460 W 10TH AVE
COLUMBUS OH
43210-1240
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-3733
  • Fax:
Mailing address:
  • Phone: 614-366-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN2776831
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberCOA08030-NS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: