Provider Demographics
NPI:1962853531
Name:DEININGER, LAUREN (PA)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:DEININGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4941 S SEDGEWICK RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1110
Mailing Address - Country:US
Mailing Address - Phone:440-915-5013
Mailing Address - Fax:
Practice Address - Street 1:4941 S SEDGEWICK RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-1110
Practice Address - Country:US
Practice Address - Phone:440-915-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant