Healthcare Provider Details

I. General information

NPI: 1609764331
Provider Name (Legal Business Name): LAUREN MARIE MCGRANN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 GORDON DR
EXTON PA
19341-1253
US

IV. Provider business mailing address

118 WINDRIDGE DR
WEST CHESTER PA
19380-3940
US

V. Phone/Fax

Practice location:
  • Phone: 610-363-1330
  • Fax:
Mailing address:
  • Phone: 443-617-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberSP033105
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: