Healthcare Provider Details

I. General information

NPI: 1295657344
Provider Name (Legal Business Name): LAUREN SOHM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 HARRY S TRUMAN DR N
LARGO MD
20774-5477
US

IV. Provider business mailing address

104 LEATHER FERN WAY
FREDERICK MD
21702-4473
US

V. Phone/Fax

Practice location:
  • Phone: 240-677-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR260444
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: