Healthcare Provider Details

I. General information

NPI: 1710498092
Provider Name (Legal Business Name): LAUREN VANCE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA PELTZ PA-C

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 MACKENZIE WAY SUITE 400
CRANBERRY TWP PA
16066
US

IV. Provider business mailing address

2030 MACKENZIE WAY SUITE 400
CRANBERRY TWP PA
16066
US

V. Phone/Fax

Practice location:
  • Phone: 724-720-5959
  • Fax: 724-772-8276
Mailing address:
  • Phone: 724-720-5959
  • Fax: 724-772-8276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA059441
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA059441
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: