Provider Demographics
NPI:1114401379
Name:KARESH, LAUREN (CNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KARESH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2563 S COUNTY HIGHWAY 395
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-6328
Mailing Address - Country:US
Mailing Address - Phone:404-281-0904
Mailing Address - Fax:404-977-4389
Practice Address - Street 1:2563 S COUNTY HIGHWAY 395
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-6328
Practice Address - Country:US
Practice Address - Phone:404-281-0904
Practice Address - Fax:404-977-4389
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-23
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023542363LF0000X
GARN207049363LF0000X
FLAPRN11027875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily