Provider Demographics
NPI:1982481479
Name:KIN, LAUREN (CRNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KIN
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4190 CITY AVE STE 528
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1635
Mailing Address - Country:US
Mailing Address - Phone:800-964-4364
Mailing Address - Fax:
Practice Address - Street 1:1055 WESTLAKES DR STE 3152
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-2410
Practice Address - Country:US
Practice Address - Phone:215-346-6050
Practice Address - Fax:215-220-3652
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2023084770363LA2200X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology