Healthcare Provider Details

I. General information

NPI: 1932557295
Provider Name (Legal Business Name): LEA M WITT NP-C, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEA M WITT NP-C, DNP

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BUCKLES CT N STE 1A
COLUMBUS OH
43230-6928
US

IV. Provider business mailing address

680 BUCKLES CT N STE 1A
COLUMBUS OH
43230-6928
US

V. Phone/Fax

Practice location:
  • Phone: 614-986-0125
  • Fax: 614-237-1646
Mailing address:
  • Phone: 614-986-0125
  • Fax: 614-237-1646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.19150
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: