Female

Mrs. Audrey Havens PA-C

Medical Physician Assistant in Elyria, OH(View on Map)

Full Name

Mrs. Audrey Havens PA-C

NPI Number

1053885624

NPI Type

Individual Provider

Gender

Female

Enumeration Date

01/17/2019

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Ohio

License Number

50.005775RX

Contact
Information

Purpose

Mailing
Location

Address

3417 W 148TH ST
125 E BROAD ST

City

Cleveland
Elyria

State

OH
OH

Postal Code

44111-2119
44035-6400

Country

US
US

Telephone Number

(330) 241-3202
(440) 406-5500

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/06/2023

Provider Address

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