Provider Demographics
NPI:1295857852
Name:PAUL, BECKY LYNN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:LYNN
Last Name:PAUL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:LYNN
Other - Last Name:TONN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:920 N HAMILTON RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1757
Mailing Address - Country:US
Mailing Address - Phone:614-293-3668
Mailing Address - Fax:
Practice Address - Street 1:920 N HAMILTON RD
Practice Address - Street 2:SUITE 600
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1757
Practice Address - Country:US
Practice Address - Phone:614-293-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10669-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3043870Medicaid
OH3043870Medicaid