Healthcare Provider Details

I. General information

NPI: 1134597016
Provider Name (Legal Business Name): LAUREN DEXTER MILLER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN NICOLE DEXTER

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2294 OCEAN HWY W # 17
SUPPLY NC
28462-4024
US

IV. Provider business mailing address

2294 OCEAN HWY W # 17
SUPPLY NC
28462-4024
US

V. Phone/Fax

Practice location:
  • Phone: 910-755-2428
  • Fax:
Mailing address:
  • Phone: 910-755-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number30002416
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: