Healthcare Provider Details

I. General information

NPI: 1730962119
Provider Name (Legal Business Name): VALERIE LOGAN APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E BROAD ST
COLUMBUS OH
43213-1502
US

IV. Provider business mailing address

33 S 5TH ST
ZANESVILLE OH
43701-3510
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-6526
  • Fax:
Mailing address:
  • Phone: 740-891-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.0034644
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0034644
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: