Healthcare Provider Details

I. General information

NPI: 1619657244
Provider Name (Legal Business Name): LAUREN BAKER SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 MARKET ST STE 202
TALLAHASSEE FL
32312-1759
US

IV. Provider business mailing address

1350 MARKET ST STE 202
TALLAHASSEE FL
32312-1759
US

V. Phone/Fax

Practice location:
  • Phone: 850-900-1971
  • Fax:
Mailing address:
  • Phone: 850-900-1971
  • Fax: 850-312-5493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11027518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: