Provider Demographics
NPI:1558188441
Name:LEVINE, LAUREN (CLC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2569 OLD CLARKSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-3222
Mailing Address - Country:US
Mailing Address - Phone:831-601-1693
Mailing Address - Fax:
Practice Address - Street 1:2569 OLD CLARKSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-3222
Practice Address - Country:US
Practice Address - Phone:831-601-1693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula