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General NPI Number Information
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NPI Number | 1033742846
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Entity Type | Individual
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Provider Name | LAUREN ERIN MEWSHAW FNP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 634 PARK AVE
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City | HUNTINGTON
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State | NY
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Zip | 11743-3881
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Country | US
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Telephone | 631-377-5053
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Fax |
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Provider Business Mailing Address
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Address Line | 25 TEXACO AVE APT 307
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2282
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Country | US
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Telephone | 330-397-9053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F345525-01
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License Number State | NY
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