Provider Demographics
NPI:1124749585
Name:POSLOCK, LAUREN ELISABETH (NP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISABETH
Last Name:POSLOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7036 RIDGE AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-4253
Mailing Address - Country:US
Mailing Address - Phone:610-790-7448
Mailing Address - Fax:
Practice Address - Street 1:5401 OLD YORK ROAD
Practice Address - Street 2:KLEIN BUILDING, SUITE 401
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141
Practice Address - Country:US
Practice Address - Phone:215-456-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026227363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care