Healthcare Provider Details

I. General information

NPI: 1528933173
Provider Name (Legal Business Name): LAUREN ELLYSE MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 TRENT DR
DURHAM NC
27710-3038
US

IV. Provider business mailing address

10567 TIGER PT
LONE TREE CO
80124-9583
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-4248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPN.1002028-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: