Healthcare Provider Details

I. General information

NPI: 1194425504
Provider Name (Legal Business Name): LAUREN OLIVIA BARRETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 BOILING SPRINGS RD
GREER SC
29650-4139
US

IV. Provider business mailing address

415 W GOLF RD STE 26
ARLINGTON HEIGHTS IL
60005-3923
US

V. Phone/Fax

Practice location:
  • Phone: 855-700-8184
  • Fax:
Mailing address:
  • Phone: 855-700-8184
  • Fax: 224-633-1935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25121
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number25121
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: