Healthcare Provider Details

I. General information

NPI: 1114330115
Provider Name (Legal Business Name): LAUREN FAGER APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SE MADISON ST
TOPEKA KS
66607-1299
US

IV. Provider business mailing address

6118 SW 38TH TER
TOPEKA KS
66610-1307
US

V. Phone/Fax

Practice location:
  • Phone: 785-368-2437
  • Fax:
Mailing address:
  • Phone: 785-221-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-76180-052
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number53-76180-052
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: