Provider Demographics
NPI:1104113414
Name:DEBRUYN, LAUREN (CNIM)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DEBRUYN
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24387
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202-4387
Mailing Address - Country:US
Mailing Address - Phone:615-928-6075
Mailing Address - Fax:615-457-1447
Practice Address - Street 1:700 12TH AVE S UNIT 306
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-3367
Practice Address - Country:US
Practice Address - Phone:615-928-6075
Practice Address - Fax:615-457-1447
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist