Provider Demographics
NPI:1083206551
Name:PICA, LAUREN MAYFIELD (APRN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MAYFIELD
Last Name:PICA
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 1:6190 SHAMROCK CT STE 110
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-1279
Mailing Address - Country:US
Mailing Address - Phone:614-467-8200
Mailing Address - Fax:
Practice Address - Street 1:6190 SHAMROCK CT STE 110
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1279
Practice Address - Country:US
Practice Address - Phone:614-467-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-06
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0028363363LF0000X
OHAPRN.CNP.0028363363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care