Healthcare Provider Details

I. General information

NPI: 1740852193
Provider Name (Legal Business Name): LAUREN ECKMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2858 SW VILLA WEST DR
TOPEKA KS
66614-5473
US

IV. Provider business mailing address

2858 SW VILLA WEST DR
TOPEKA KS
66614-5473
US

V. Phone/Fax

Practice location:
  • Phone: 913-498-9626
  • Fax:
Mailing address:
  • Phone: 636-697-5366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-82900-071
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2024005319
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number141701
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: