Individual
MS. LAUREN MARIE BALUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7630 SOUTHERN BLVD, YOUNGSTOWN, OH 44512
(330) 729-8011
(330) 729-8084
Mailing address
7630 SOUTHERN BLVD, YOUNGSTOWN, OH 44512-5633
(330) 729-8011
(330) 729-8084
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN337180
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
91437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111704
—
OH
01
—
H369340
MEDICARE PTAN
OH
Enumeration date
04/03/2013
Last updated
02/15/2019
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