MEDICARE: LINDSEY R. TANN APRN-CNP

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	363L00000X	Nurse Practitioner	APRN.CNP.16023	OH
2	363LF0000X	Family Nurse Practitioner	COA.16023-NP	OH

General Provider Information

NPI Number	:	1447658026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY R. TANN APRN-CNP

Provider Business Mailing Address
First Line	:	2939 KENNY RD 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2406
Country	:	US
Telephone Number	:	614-442-2431
Fax Number	:	440-442-2426

Provider Business Practice Location Address
First Line	:	445 ROCKY FORK BLVD
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-3336
Country	:	US
Telephone Number	:	614-383-7660
Fax Number	:	614-383-7665

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

Provider Enumeration Date	:	12/12/2014
Last Update Date	:	07/07/2022

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