Healthcare Provider Details

I. General information

NPI: 1548992712
Provider Name (Legal Business Name): LAUREN MEBANE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN WENDT NP

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 AURORA CT
AURORA CO
80045-2541
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN.1648842
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN.0997935-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0997935-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: