Provider Demographics
NPI:1215348354
Name:MANLEY, LAUREN HUDSON (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:HUDSON
Last Name:MANLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ASHLEY
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9055 KATY FWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1624
Mailing Address - Country:US
Mailing Address - Phone:713-461-2915
Mailing Address - Fax:713-461-5307
Practice Address - Street 1:1105 W FRANK AVE STE 200
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3395
Practice Address - Country:US
Practice Address - Phone:936-631-6771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX768602163W00000X
TXAP125464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse