Provider Demographics
NPI:1285129296
Name:MINDZORA, LAUREN M (CNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:MINDZORA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 HILLIARY LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9807
Mailing Address - Country:US
Mailing Address - Phone:440-823-2031
Mailing Address - Fax:
Practice Address - Street 1:6681 RIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5705
Practice Address - Country:US
Practice Address - Phone:440-842-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022914363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner