Provider Demographics
NPI:1558196576
Name:PREBLE, LAUREN (RN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PREBLE
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 1:1630 E CULVER ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-3021
Mailing Address - Country:US
Mailing Address - Phone:520-270-4090
Mailing Address - Fax:
Practice Address - Street 1:10599 N TATUM BLVD STE F151
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1053
Practice Address - Country:US
Practice Address - Phone:480-991-9271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230531163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse