Healthcare Provider Details

I. General information

NPI: 1255150108
Provider Name (Legal Business Name): LAUREN N THOMPSON MHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 SAINT STEPHENS CHURCH RD
CROWNSVILLE MD
21032-2205
US

IV. Provider business mailing address

1315 SAINT STEPHENS CHURCH RD
CROWNSVILLE MD
21032-2205
US

V. Phone/Fax

Practice location:
  • Phone: 571-217-7403
  • Fax:
Mailing address:
  • Phone: 571-217-7403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number362742
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number5-202413
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: