MEDICARE: LAUREN SCOTT RAY WHNP

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	363LW0102X	Women's Health Nurse Practitioner	25431	TN

General Provider Information

NPI Number	:	1851956445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SCOTT RAY WHNP

Provider Business Mailing Address
First Line	:	3563 CHARLESWOOD AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-4505
Country	:	US
Telephone Number	:	901-921-5906
Fax Number	:

Provider Business Practice Location Address
First Line	:	2996 KATE BOND RD STE 413
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38133-4063
Country	:	US
Telephone Number	:	901-937-0038
Fax Number	:

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

Provider Enumeration Date	:	05/08/2019
Last Update Date	:	06/15/2021

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