MEDICARE: MONA LEE-ANN LLOYD FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	APRN.CNP.0038614	OH

General Provider Information

NPI Number	:	1164236774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONA LEE-ANN LLOYD FNP-C

Provider Business Mailing Address
First Line	:	6480 N RIVER RD
Second Line	:
City	:	SOUTH CHARLESTON
State	:	OH
Zip	:	45368-8605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 E HIGH ST
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45505-1410
Country	:	US
Telephone Number	:	937-629-3105
Fax Number	:	937-521-1503

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	03/17/2025

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