Healthcare Provider Details

I. General information

NPI: 1336554369
Provider Name (Legal Business Name): LAUREN E. WHEELER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN E. HOLMGREN M.D.

II. Dates (important events)

Enumeration Date: 06/28/2014
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 NASHVILLE HWY
COLUMBIA TN
38401-2069
US

IV. Provider business mailing address

1600 NASHVILLE HWY
COLUMBIA TN
38401-2069
US

V. Phone/Fax

Practice location:
  • Phone: 270-782-8700
  • Fax: 270-782-8704
Mailing address:
  • Phone: 931-388-8965
  • Fax: 931-388-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125.065068
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50108
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: