Healthcare Provider Details

I. General information

NPI: 1033954128
Provider Name (Legal Business Name): LAUREN ELIZABETH ADKINS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6969 BROCKTON AVE STE AB
RIVERSIDE CA
92506-3833
US

IV. Provider business mailing address

13068 PAVILLION CT
MORENO VALLEY CA
92553-5696
US

V. Phone/Fax

Practice location:
  • Phone: 951-530-8989
  • Fax: 951-530-8877
Mailing address:
  • Phone: 951-497-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95242013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: