Provider Demographics
NPI:1720477409
Name:PRICE, LAUREN (NP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:460 MALL BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4801
Mailing Address - Country:US
Mailing Address - Phone:912-644-1626
Mailing Address - Fax:912-644-3369
Practice Address - Street 1:121 N CREST BLVD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1845
Practice Address - Country:US
Practice Address - Phone:478-841-9333
Practice Address - Fax:478-272-3139
Is Sole Proprietor?:No
Enumeration Date:2015-01-17
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN200058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily