Provider Demographics
NPI:1427826692
Name:FOURNIER, LAUREN J (APRN, PMHN-BC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:J
Last Name:FOURNIER
Suffix:
Gender:F
Credentials:APRN, PMHN-BC
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:J
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 RANDOM RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1406
Mailing Address - Country:US
Mailing Address - Phone:203-868-9520
Mailing Address - Fax:
Practice Address - Street 1:47 LONG LOTS RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3828
Practice Address - Country:US
Practice Address - Phone:203-227-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12806363LP0808X
CT144761163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health