Healthcare Provider Details
I. General information
NPI: 1154315257
Provider Name (Legal Business Name): LAURA A POPELAR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/02/2005
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
931 CHATHAM LN
COLUMBUS OH
43221-2417
US
IV. Provider business mailing address
5350 FRANTZ RD
DUBLIN OH
43016-4259
US
V. Phone/Fax
- Phone: 614-533-5500
- Fax: 614-533-5593
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | COA.05022-NP |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: