Healthcare Provider Details

I. General information

NPI: 1033314950
Provider Name (Legal Business Name): LORI BOEDIGHEIMER MUETZEL APRN.CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 THOMAS LN STE 1A
COLUMBUS OH
43214-1419
US

IV. Provider business mailing address

500 THOMAS LN STE 1A
COLUMBUS OH
43214-1419
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-4785
  • Fax:
Mailing address:
  • Phone: 614-566-4785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.08381
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP 08381
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: