Provider Demographics
NPI:1386916740
Name:LAUVRAY, MEGAN D (NP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:D
Last Name:LAUVRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7756 WASHINGTON VILLAGE DR STE 145
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3999
Mailing Address - Country:US
Mailing Address - Phone:937-610-3220
Mailing Address - Fax:937-610-3225
Practice Address - Street 1:3533 SOUTHERN BLVD
Practice Address - Street 2:SUITE 4300
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1272
Practice Address - Country:US
Practice Address - Phone:937-610-3220
Practice Address - Fax:937-610-3225
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA13112NP363L00000X
OHCOA13112-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA13112NPOtherOHIO LICENSE
OHAPPLIED/PENDINGMedicaid
OH0087198Medicaid
OHAPPLIED/PENDINGMedicare PIN