Healthcare Provider Details

I. General information

NPI: 1396461307
Provider Name (Legal Business Name): LAUREN ELIZABETH HULL DNP, APRN, PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2423
US

IV. Provider business mailing address

4988 CAVELLETTI RD
LAKE WORTH FL
33467-6713
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-1515
  • Fax:
Mailing address:
  • Phone: 636-887-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11022306
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: