Healthcare Provider Details

I. General information

NPI: 1063995405
Provider Name (Legal Business Name): LAUREN ZUGA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 E MARKET ST
WARREN OH
44483-6638
US

IV. Provider business mailing address

915 PERKINS JONES RD NE
WARREN OH
44483-1853
US

V. Phone/Fax

Practice location:
  • Phone: 330-856-7212
  • Fax:
Mailing address:
  • Phone: 330-979-1058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.023507
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: