Healthcare Provider Details

I. General information

NPI: 1437018934
Provider Name (Legal Business Name): COMMUNITY CARE COACHING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13195 COVENTRY AVE
PICKERINGTON OH
43147-9331
US

IV. Provider business mailing address

1608 DREAM CT
REYNOLDSBURG OH
43068-1576
US

V. Phone/Fax

Practice location:
  • Phone: 614-597-6071
  • Fax:
Mailing address:
  • Phone: 614-597-6071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. AUDRA LYNNE HANNERS
Title or Position: OWNER/NURSE PRACTITIONER
Credential: DNP, APRN-CNP
Phone: 614-597-6071