Provider Demographics
NPI:1003613613
Name:LAUTER, LORELAI ANN
Entity type:Individual
Prefix:
First Name:LORELAI
Middle Name:ANN
Last Name:LAUTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11193 RAVENNA AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9783
Mailing Address - Country:US
Mailing Address - Phone:330-605-6292
Mailing Address - Fax:
Practice Address - Street 1:11193 RAVENNA AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-9783
Practice Address - Country:US
Practice Address - Phone:330-605-6282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-01
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6025588902233747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant