Healthcare Provider Details

I. General information

NPI: 1881147478
Provider Name (Legal Business Name): LYNN CHRISTIAN WARDLOW PHARMD, BCPS-AQ ID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN CHRISTIAN NELSON PHARMD, BCPS-AQ ID

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 07/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE 368 DOAN HALL
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

410 W 10TH AVE 368 DOAN HALL
COLUMBUS OH
43210-1240
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8470
  • Fax: 614-293-3165
Mailing address:
  • Phone: 614-293-8470
  • Fax: 614-293-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03136189
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: