Healthcare Provider Details

I. General information

NPI: 1073132395
Provider Name (Legal Business Name): KRISTEN LAUERMAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10539 HARRISON AVE
HARRISON OH
45030-1943
US

IV. Provider business mailing address

PO BOX 207170
DALLAS TX
75320-7156
US

V. Phone/Fax

Practice location:
  • Phone: 513-367-6199
  • Fax:
Mailing address:
  • Phone: 636-200-4393
  • Fax: 636-527-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.007516
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: