Provider Demographics
NPI:1275032211
Name:HENRY, LAUREN N (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:N
Last Name:HENRY
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 1:7794 5 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2368
Mailing Address - Country:US
Mailing Address - Phone:513-246-2300
Mailing Address - Fax:513-487-4341
Practice Address - Street 1:7794 5 MILE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2368
Practice Address - Country:US
Practice Address - Phone:513-246-2300
Practice Address - Fax:513-487-4341
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1150750363A00000X
OH50.005408363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant