Healthcare Provider Details

I. General information

NPI: 1710051438
Provider Name (Legal Business Name): LAUREN OUTLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN OUTLAND NP

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E VICTORIA ST SCHOOL OF NURSING
CARSON CA
90747-0001
US

IV. Provider business mailing address

1000 E VICTORIA ST SCHOOL OF NURSING
CARSON CA
90747-0001
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3714
  • Fax:
Mailing address:
  • Phone: 310-222-3714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number401360
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number18779
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: