Provider Demographics
NPI:1184868887
Name:HEARN, TEGAN NICOLE (LPN)
Entity type:Individual
Prefix:
First Name:TEGAN
Middle Name:NICOLE
Last Name:HEARN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 COMPTON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3323
Mailing Address - Country:US
Mailing Address - Phone:614-475-0770
Mailing Address - Fax:
Practice Address - Street 1:3380 COMPTON DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3323
Practice Address - Country:US
Practice Address - Phone:614-475-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN116511164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse