Healthcare Provider Details

I. General information

NPI: 1023436292
Provider Name (Legal Business Name): LYNSEY AREY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 27TH ST BRAUNLIN BUILDING SUITE 306
PORTSMOUTH OH
45662-2654
US

IV. Provider business mailing address

1805 27TH ST
PORTSMOUTH OH
45662-2640
US

V. Phone/Fax

Practice location:
  • Phone: 740-353-8661
  • Fax: 740-354-3254
Mailing address:
  • Phone:
  • Fax: 740-354-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA 15765-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: