Provider Demographics
NPI:1538546049
Name:LEHMANN, SHELLY ANN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:ANN
Last Name:LEHMANN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3269
Mailing Address - Country:US
Mailing Address - Phone:419-355-8070
Mailing Address - Fax:419-355-1109
Practice Address - Street 1:605 3RD AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3269
Practice Address - Country:US
Practice Address - Phone:419-355-8070
Practice Address - Fax:419-355-1109
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA17291-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0131740Medicaid