Healthcare Provider Details

I. General information

NPI: 1538095757
Provider Name (Legal Business Name): LAUREN IRWIN RN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN E WICKER

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SYCAMORE CT STE 1B
COLUMBUS IN
47203-1545
US

IV. Provider business mailing address

3200 SYCAMORE CT STE 1B
COLUMBUS IN
47203-1545
US

V. Phone/Fax

Practice location:
  • Phone: 812-378-9027
  • Fax: 812-378-1014
Mailing address:
  • Phone: 812-378-9027
  • Fax: 812-378-1014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28243461A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: