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NPI Code Detail

MEDICARE: LAUREN ELIZABETH SILLAMAN FNP

MEDICARE: LAUREN ELIZABETH SILLAMAN FNP
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
1363LF0000XFamily Nurse PractitionerCOA.18793-NPOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184083107
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ELIZABETH SILLAMAN FNP
Provider Business Mailing Address
First Line : 3170 KETTERING BLVD
Second Line : BLDG B 3RD FLOOR
City : MORAINE
State : OH
Zip : 45439-1924
Country : US
Telephone Number : 937-991-3188
Fax Number : 937-223-9811
Provider Business Practice Location Address
First Line : 68 DARST RD
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45440-3442
Country : US
Telephone Number : 937-531-0132
Fax Number : 937-531-0134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2016
Last Update Date : 05/21/2021

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