Provider Demographics
NPI:1962897769
Name:MCNEIL, LAURA LYNN (APRN-CNP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LYNN
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-366-6255
Mailing Address - Fax:614-293-8518
Practice Address - Street 1:410 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-366-6255
Practice Address - Fax:614-293-8518
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRNCNP14075363LF0000X, 363LF0000X
OHCOA.14075-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0135938Medicaid