Provider Demographics
NPI:1568017911
Name:EDWARDS, LAUREN ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:EDWARDS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 HIGHWAY 421 N
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40006-8690
Mailing Address - Country:US
Mailing Address - Phone:502-255-7732
Mailing Address - Fax:
Practice Address - Street 1:470 HIGHWAY 421 N
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:KY
Practice Address - Zip Code:40006-8690
Practice Address - Country:US
Practice Address - Phone:502-255-7732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09510363A00000X
SC3819363A00000X
IN363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant