Provider Demographics
NPI:1124460217
Name:EARLEY, LAUREN RAE (PA-C)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:RAE
Last Name:EARLEY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:RAE
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:355 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97448-1313
Mailing Address - Country:US
Mailing Address - Phone:541-998-6750
Mailing Address - Fax:541-998-8270
Practice Address - Street 1:355 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OR
Practice Address - Zip Code:97448-1313
Practice Address - Country:US
Practice Address - Phone:541-998-6750
Practice Address - Fax:541-998-8270
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016734363AM0700X
ORPA185443363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03690342Medicaid
NY03690342Medicaid