Healthcare Provider Details

I. General information

NPI: 1871259564
Provider Name (Legal Business Name): LAUREN BENTLEY APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W LIBERTY ST STE 4
HUBBARD OH
44425-1753
US

IV. Provider business mailing address

21 FAIRLAWN AVE
BOARDMAN OH
44512-1506
US

V. Phone/Fax

Practice location:
  • Phone: 814-333-5438
  • Fax: 814-333-5439
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0030191
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: