Healthcare Provider Details

I. General information

NPI: 1912521014
Provider Name (Legal Business Name): TODD EDMOND DEAN MSN, APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 HILL RD N
PICKERINGTON OH
43147-8659
US

IV. Provider business mailing address

1100 HILL RD N
PICKERINGTON OH
43147-8659
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 508-630-0222
Mailing address:
  • Phone: 866-389-2727
  • Fax: 508-630-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0026799
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0026799
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCNP.APRN.0026799
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: