Provider Demographics
NPI:1255037743
Name:POSLAIKO, LAUREN M (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:POSLAIKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 HUGHES DR # 310
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3857
Mailing Address - Country:US
Mailing Address - Phone:419-291-3858
Mailing Address - Fax:
Practice Address - Street 1:2121 HUGHES DR # 310
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3857
Practice Address - Country:US
Practice Address - Phone:419-291-3858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5397363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant