Healthcare Provider Details

I. General information

NPI: 1730762592
Provider Name (Legal Business Name): LAUREN ASHLEY LEE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HWY 247 SPUR
PERRY GA
31069-9211
US

IV. Provider business mailing address

114 ABBY GAIL LN
PERRY GA
31069-2450
US

V. Phone/Fax

Practice location:
  • Phone: 478-988-6031
  • Fax: 410-341-8105
Mailing address:
  • Phone: 478-235-0835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP267753
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: