Provider Demographics
NPI:1083035307
Name:MCGRATH, LAUREN ASHLEY (CRNP)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ASHLEY
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 CHESTNUT ST FL 15
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3612
Mailing Address - Country:US
Mailing Address - Phone:215-955-1888
Mailing Address - Fax:
Practice Address - Street 1:1101 CHESTNUT ST FL 15
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3612
Practice Address - Country:US
Practice Address - Phone:215-955-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-05
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016624363LA2200X
PASP013559363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102905189Medicaid
PA345285Medicare PIN