Healthcare Provider Details

I. General information

NPI: 1801576236
Provider Name (Legal Business Name): LAUREN B DUNCAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 GREENFIELD DR
TIFTON GA
31794-3794
US

IV. Provider business mailing address

2400 BELLEVUE RD STE 21A
DUBLIN GA
31021-2890
US

V. Phone/Fax

Practice location:
  • Phone: 229-386-9333
  • Fax: 229-386-1666
Mailing address:
  • Phone: 478-328-0281
  • Fax: 478-328-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN248870
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN248870
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: