Healthcare Provider Details

I. General information

NPI: 1811247992
Provider Name (Legal Business Name): LAUREN HEATON CREPEAU NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 10/12/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901-B PEACHTREE DUNWOODY ROAD SUITE B-420
ATLANTA GA
30328-7156
US

IV. Provider business mailing address

320 GREEN OAK RDG
MARIETTA GA
30068-4808
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-9751
  • Fax: 404-255-5783
Mailing address:
  • Phone: 404-915-6347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberRN184100
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN184100
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: