Healthcare Provider Details

I. General information

NPI: 1851943724
Provider Name (Legal Business Name): MENDY LAFON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 01/25/2022
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 GLESSNER AVE FL 5
MANSFIELD OH
44903-2269
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 419-522-2833
  • Fax: 419-524-1619
Mailing address:
  • Phone: 614-533-6535
  • Fax: 614-544-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.024806
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: