Healthcare Provider Details

I. General information

NPI: 1588515134
Provider Name (Legal Business Name): LAUREN MARIE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 JOHN WESLEY GILBERT DRIVE
AUGUSTA GA
30912-0001
US

IV. Provider business mailing address

7001 WILLOW TRACE LN
WEDDINGTON NC
28104-6804
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2371
  • Fax:
Mailing address:
  • Phone: 704-533-4716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: