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General NPI Number Information
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NPI Number | 1083267082
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Entity Type | Individual
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Provider Name | LAUREN MCDONNELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 129 N DUPONT HWY
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City | NEW CASTLE
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State | DE
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Zip | 19720-3135
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Country | US
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Telephone | 302-328-5150
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Fax |
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Provider Business Mailing Address
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Address Line | 8 SUSAN CT
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City | WILMINGTON
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State | DE
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Zip | 19803-3969
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Country | US
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Telephone | 302-521-6615
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0009380
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0001327
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License Number State | DE
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