Provider Demographics
NPI:1629706106
Name:DEATON-LAMPLEY, TRICIA NICOLE (FNP)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:NICOLE
Last Name:DEATON-LAMPLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 W NATIONAL RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45315
Mailing Address - Country:US
Mailing Address - Phone:707-999-0308
Mailing Address - Fax:
Practice Address - Street 1:1250 W NATIONAL RD STE 400
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45315-9506
Practice Address - Country:US
Practice Address - Phone:937-836-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA846058163W00000X
CA95022136363L00000X, 363LF0000X
OHAPRN.CNP.0038935363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty