Healthcare Provider Details

I. General information

NPI: 1720812035
Provider Name (Legal Business Name): LAUREN FAITH LEMONS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 POST OFFICE RD STE 102
WALDORF MD
20602-1913
US

IV. Provider business mailing address

605 POST OFFICE RD STE 102
WALDORF MD
20602-1913
US

V. Phone/Fax

Practice location:
  • Phone: 301-374-2666
  • Fax:
Mailing address:
  • Phone: 301-374-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009952
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberNO.50.009139RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: