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: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W CENTRAL AVE
DELAWARE OH
43015-1421
US

IV. Provider business mailing address

550 W CENTRAL AVE
DELAWARE OH
43015-1421
US

V. Phone/Fax

Practice location:
  • Phone: 740-363-1904
  • Fax: 740-363-5288
Mailing address:
  • Phone: 740-363-1904
  • Fax: 740-363-5288

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: