Provider Demographics
NPI:1316247372
Name:CARRIER, LAUREN RENEE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:RENEE
Last Name:CARRIER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 ROUTE 58
Mailing Address - Street 2:STE 1
Mailing Address - City:PARKER
Mailing Address - State:PA
Mailing Address - Zip Code:16049-7029
Mailing Address - Country:US
Mailing Address - Phone:724-659-5601
Mailing Address - Fax:
Practice Address - Street 1:855 ROUTE 58
Practice Address - Street 2:STE 1
Practice Address - City:PARKER
Practice Address - State:PA
Practice Address - Zip Code:16049-7029
Practice Address - Country:US
Practice Address - Phone:724-659-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054799363AS0400X, 363AM0700X
PAOA002625363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical