MEDICARE: MISTY LOYD CPNP-PC

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	363LP0200X	Pediatric Nurse Practitioner	APRN.CNP.07893	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1568428720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISTY LOYD CPNP-PC

Provider Business Mailing Address
First Line	:	4885 OLENTANGY RIVER RD STE 1-10
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1953
Country	:	US
Telephone Number	:	614-891-4705
Fax Number	:	614-568-8050

Provider Business Practice Location Address
First Line	:	4885 OLENTANGY RIVER RD STE 1-10
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1953
Country	:	US
Telephone Number	:	614-891-4705
Fax Number	:	614-568-8050

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	12/24/2025

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Directions to “ MISTY LOYD CPNP-PC” Practice Location

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