Healthcare Provider Details

I. General information

NPI: 1326512534
Provider Name (Legal Business Name): LAUREN MEADOWS HEILMAN CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4109 WAKE FOREST RD STE 300
RALEIGH NC
27609-2508
US

IV. Provider business mailing address

2216 DAHLGREEN RD
RALEIGH NC
27615-4069
US

V. Phone/Fax

Practice location:
  • Phone: 919-250-3478
  • Fax: 919-250-6272
Mailing address:
  • Phone: 919-656-6247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5011381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: