Healthcare Provider Details

I. General information

NPI: 1265740872
Provider Name (Legal Business Name): STACEY LYNN LLOYD APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY L. KINGERY

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 KENNY RD FL 1
COLUMBUS OH
43221-3502
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-7500
  • Fax: 614-366-7560
Mailing address:
  • Phone: 614-366-7500
  • Fax: 614-366-7560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.11723
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.11723
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: