Provider Demographics
NPI:1427494657
Name:SWEITZER, LAUREN A
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:SWEITZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 COMMUNITY HOME PARK
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-9068
Mailing Address - Country:US
Mailing Address - Phone:877-230-3885
Mailing Address - Fax:
Practice Address - Street 1:11506 NICHOLAS ST STE 110
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4421
Practice Address - Country:US
Practice Address - Phone:877-230-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5664224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant