Healthcare Provider Details

I. General information

NPI: 1902675606
Provider Name (Legal Business Name): LAUREN ELAINE ESQUINCA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 12/22/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 LA PITA MANGANA ROAD UNIT 100
LAREDO TX
78045
US

IV. Provider business mailing address

4007 SHAHRAM DR
LAREDO TX
78045-4505
US

V. Phone/Fax

Practice location:
  • Phone: 956-568-1350
  • Fax:
Mailing address:
  • Phone: 956-441-5276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1145627
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: