Healthcare Provider Details

I. General information

NPI: 1306587787
Provider Name (Legal Business Name): MRS. LINDSAY RENEE LAUENER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 12/13/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 6TH ST SW
CANTON OH
44710-1702
US

IV. Provider business mailing address

5747 EASTVIEW ST
LOUISVILLE OH
44641-8621
US

V. Phone/Fax

Practice location:
  • Phone: 330-452-9911
  • Fax:
Mailing address:
  • Phone: 330-581-9554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SN0000X
TaxonomyNeonatal Clinical Nurse Specialist
License Number0031691
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN375530
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: