Healthcare Provider Details

I. General information

NPI: 1922495803
Provider Name (Legal Business Name): LAUREN ALYSE BOZZO MCCARRON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2015
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2797 NC 55 HWY
CARY NC
27519-6206
US

IV. Provider business mailing address

3610 MATTHEWS MINT HILL RD
MATTHEWS NC
28105-3605
US

V. Phone/Fax

Practice location:
  • Phone: 866-369-2727
  • Fax: 401-652-9787
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberBOZZ-HM71S8
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: