Healthcare Provider Details

I. General information

NPI: 1982209995
Provider Name (Legal Business Name): NANCY LYTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 COUNTY LINE RD
WESTERVILLE OH
43081-6015
US

IV. Provider business mailing address

651 CONCORD CT
WESTERVILLE OH
43081-2710
US

V. Phone/Fax

Practice location:
  • Phone: 614-891-8300
  • Fax:
Mailing address:
  • Phone: 614-895-1229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03213945
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: