Provider Demographics
NPI:1063024065
Name:LOK, TANNA LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:TANNA
Middle Name:LYNN
Last Name:LOK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-8923
Mailing Address - Country:US
Mailing Address - Phone:614-387-0588
Mailing Address - Fax:614-877-7038
Practice Address - Street 1:4545 FISHER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-8923
Practice Address - Country:US
Practice Address - Phone:614-387-0588
Practice Address - Fax:614-877-7038
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.026123363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health