Healthcare Provider Details

I. General information

NPI: 1881511731
Provider Name (Legal Business Name): LAUREN MARGARET PETERS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

5793 MIDSTREAM CIR
CLEMMONS NC
27012-9691
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-0916
  • Fax:
Mailing address:
  • Phone: 717-743-0974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: