Healthcare Provider Details

I. General information

NPI: 1427910983
Provider Name (Legal Business Name): EMILY LAYNE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W MAIN ST STE 330
TROY OH
45373-3384
US

IV. Provider business mailing address

1 PRESTIGE PL STE 550
MIAMISBURG OH
45342-6115
US

V. Phone/Fax

Practice location:
  • Phone: 937-980-7400
  • Fax: 937-980-7441
Mailing address:
  • Phone: 937-762-1306
  • Fax: 937-522-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP034259
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: