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General NPI Number Information
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NPI Number | 1326769092
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Entity Type | Individual
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Provider Name | LAUREN ALEXANDRA SHADDOX APRN, CNM
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Gender | Female
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 10/10/2026
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Provider Practice Location Address
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Address Line | 1701 SOUTH BLVD E STE 200
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6116
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Country | US
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Telephone | 248-997-5805
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Fax |
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Provider Business Mailing Address
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Address Line | 585 DORCHESTER WAY
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City | MILFORD
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State | MI
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Zip | 48381-2791
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Country | US
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Telephone | 970-708-2321
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 4704427387
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 1096846
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704427387
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 872512
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License Number State | TX
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