Healthcare Provider Details

I. General information

NPI: 1245801687
Provider Name (Legal Business Name): LYNDSEY PURCELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date: 06/20/2024
Reactivation Date: 07/05/2024

III. Provider practice location address

2323 W 5TH AVE STE 225
COLUMBUS OH
43204-4899
US

IV. Provider business mailing address

2323 W 5TH AVE STE 225
COLUMBUS OH
43204-4899
US

V. Phone/Fax

Practice location:
  • Phone: 614-224-6420
  • Fax:
Mailing address:
  • Phone: 614-224-6420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number032462
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: