Provider Demographics
NPI:1427512078
Name:KESSLER, LAUREN NICOLE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:KESSLER
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:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:CLEAR SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:21722-0231
Mailing Address - Country:US
Mailing Address - Phone:240-835-5770
Mailing Address - Fax:
Practice Address - Street 1:150 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:CLEAR SPRING
Practice Address - State:MD
Practice Address - Zip Code:21722-1973
Practice Address - Country:US
Practice Address - Phone:240-835-5770
Practice Address - Fax:240-850-4028
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR192205363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily