Healthcare Provider Details

I. General information

NPI: 1306678057
Provider Name (Legal Business Name): LAUREN M PIRCHER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 CALUMET AVE # 203
MUNSTER IN
46321-2885
US

IV. Provider business mailing address

9200 CALUMET AVE # 203
MUNSTER IN
46321-2885
US

V. Phone/Fax

Practice location:
  • Phone: 219-228-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085010354
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10004790A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: