Provider Demographics
NPI:1699073445
Name:WHITE, LAUREN PEELER (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:PEELER
Last Name:WHITE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:E
Other - Last Name:PEELER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:982086 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-2086
Mailing Address - Country:US
Mailing Address - Phone:402-559-9500
Mailing Address - Fax:402-559-9560
Practice Address - Street 1:982086 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2086
Practice Address - Country:US
Practice Address - Phone:402-559-9500
Practice Address - Fax:402-559-9560
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1579363AM0700X, 207Q00000X
IA002372363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant