Provider Demographics
NPI:1386410330
Name:POISSON, LAUREN (RN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:POISSON
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 1:100 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-2719
Mailing Address - Country:US
Mailing Address - Phone:401-572-7760
Mailing Address - Fax:
Practice Address - Street 1:100 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-2719
Practice Address - Country:US
Practice Address - Phone:401-572-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN69936163WN1003X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support