Healthcare Provider Details

I. General information

NPI: 1508416884
Provider Name (Legal Business Name): LAUREN SHAWGO KUHN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN ISABEL SHAWGO PA-C

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 STRUTHERS LIBERTY RD STE 1
CAMPBELL OH
44405-1973
US

IV. Provider business mailing address

1197 E HOOKSTOWN GRADE RD
CLINTON PA
15026-1155
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-5050
  • Fax: 330-965-5055
Mailing address:
  • Phone: 724-480-6285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA060805
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50.006986RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: