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General NPI Number Information
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NPI Number | 1609393818
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Entity Type | Individual
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Provider Name | JUSTIN DONALD LAUDICK BSN-RN, NP-C
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Gender | Male
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 290 EAST 3RD STREET
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City | OTTOVILLE
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State | OH
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Zip | 45876
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Country | US
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Telephone | 419-675-8363
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Fax | 419-675-8299
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN.354086
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 132516
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.024177
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.024177
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License Number State | OH
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