Provider Demographics
NPI:1346645926
Name:SOBOTKA, LAUREN PALANK (MSN, RN, CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:PALANK
Last Name:SOBOTKA
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Gender:F
Credentials:MSN, RN, CPNP-PC
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Mailing Address - Street 1:3419 EDWARDS LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:118 SHAWAN RD STE 220
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-1318
Practice Address - Country:US
Practice Address - Phone:410-469-4950
Practice Address - Fax:410-601-6698
Is Sole Proprietor?:No
Enumeration Date:2014-10-25
Last Update Date:2024-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR224646363LP0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR224646OtherMARYLAND BOARD OF NURSING
20142571OtherPEDIATRIC NURSING CERTIFICATION BOARD
MD251205000Medicaid
MD196100160Medicaid