Provider Demographics
NPI:1346751625
Name:TOMELIN, AUDREY (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:TOMELIN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 MONTMORENCY DR S
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1941 W FAIR AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-9671
Practice Address - Country:US
Practice Address - Phone:740-689-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2024-07-29
Deactivation Date:2024-07-12
Deactivation Code:
Reactivation Date:2024-07-24
Provider Licenses
StateLicense IDTaxonomies
OHRN.444452163W00000X
OHAPRN.CNP.0037056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse