Provider Demographics
NPI:1679876841
Name:SHERER, LAUREN A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:A
Last Name:SHERER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:A
Other - Last Name:KIRACOFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:329 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4332
Mailing Address - Country:US
Mailing Address - Phone:419-221-3072
Mailing Address - Fax:419-549-5670
Practice Address - Street 1:111 W ESPY ST
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-2117
Practice Address - Country:US
Practice Address - Phone:419-679-5994
Practice Address - Fax:419-225-8878
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-004263363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0133562Medicaid
OH0133562Medicaid