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NPI Code Detail

MEDICARE: ARJAYRA LYNNE TREADWAY CNP

MEDICARE: ARJAYRA LYNNE TREADWAY 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
1163W00000XRegistered Nurse268217OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.0035295OH

General Provider Information

NPI Number : 1710541198
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARJAYRA LYNNE TREADWAY CNP
Provider Business Mailing Address
First Line : 1634 11TH ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-4526
Country : US
Telephone Number : 740-355-7102
Fax Number : 740-353-3083
Provider Business Practice Location Address
First Line : 1634 11TH ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-4526
Country : US
Telephone Number : 740-355-7102
Fax Number : 740-353-3083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2019
Last Update Date : 02/05/2026

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