Healthcare Provider Details

I. General information

NPI: 1972031235
Provider Name (Legal Business Name): LAUREN DULAY FNP-BC, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 S 6TH ST
TERRE HAUTE IN
47807-4214
US

IV. Provider business mailing address

7219 BOULDER FALLS CT
BAKERSFIELD CA
93312-6569
US

V. Phone/Fax

Practice location:
  • Phone: 812-232-0564
  • Fax: 812-242-4590
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number95006691
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008840A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: