Healthcare Provider Details

I. General information

NPI: 1740873082
Provider Name (Legal Business Name): LAUREN KRAUSER SHEPHERD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN ELIZABETH KRAUSER

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N PENNSYLVANIA AVE
WINTER PARK FL
32789-3773
US

IV. Provider business mailing address

300 N PENNSYLVANIA AVE
WINTER PARK FL
32789-3773
US

V. Phone/Fax

Practice location:
  • Phone: 407-628-1081
  • Fax:
Mailing address:
  • Phone: 407-628-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN9369544
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11014340
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: