Provider Demographics
NPI:1154130888
Name:WILEY, LAUREN FONDA (RN)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:FONDA
Last Name:WILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 HAWTHORNE PL
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1809
Mailing Address - Country:US
Mailing Address - Phone:337-540-8842
Mailing Address - Fax:
Practice Address - Street 1:990 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3833
Practice Address - Country:US
Practice Address - Phone:504-359-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN138690163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool