MEDICARE: LAUREN ELISE HAMLIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	367500000X	Certified Registered Nurse Anesthetist	209028873	IL

General Provider Information

NPI Number	:	1598348138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELISE HAMLIN

Provider Business Mailing Address
First Line	:	5619 SEABREEZE LN
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-7451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5619 SEABREEZE LN
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-7451
Country	:	US
Telephone Number	:	517-230-6082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2021
Last Update Date	:	01/10/2025

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