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General NPI Number Information
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NPI Number | 1346661980
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH EDDY MSN, RN, AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/28/2013
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 720-352-8663
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Fax |
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Provider Business Mailing Address
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Address Line | 209 WEST ST
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City | DOUGLAS
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State | MA
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Zip | 01516-2161
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Country | US
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Telephone | 206-795-4307
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 816865
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 153487
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License Number State | CT
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