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NPI Code Detail

MEDICARE: LAUREN PRATT FNP

MEDICARE: LAUREN PRATT FNP
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
1363L00000XNurse Practitioner35139TN

General Provider Information

NPI Number : 1891569349
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN PRATT FNP
Provider Business Mailing Address
First Line : 461 BLAKE RD
Second Line :
City : OAKDALE
State : TN
Zip : 37829-2043
Country : US
Telephone Number : 865-654-8403
Fax Number :
Provider Business Practice Location Address
First Line : 1503 S MAIN ST
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-5967
Country : US
Telephone Number : 931-484-6196
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2023
Last Update Date : 11/14/2023

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