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General NPI Number Information
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NPI Number | 1376327247
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Entity Type | Individual
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Provider Name | LAUREN BLAIR FONTENOT FNP
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Gender | Female
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | ONE KAISER PLAZA 17 BAYSIDE
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City | OAKLAND
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State | CA
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Zip | 94612-3610
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Country | US
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Telephone | 650-301-4535
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Fax |
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Provider Business Mailing Address
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Address Line | 13386 AIRLINE HWY STE B
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City | GONZALES
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State | LA
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Zip | 70737-6601
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Country | US
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Telephone | 225-310-1201
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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 | 163WI0600X
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Taxonomy Name | Infection Control Registered Nurse
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License Number | 95126679
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95029736
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 78163
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 878253
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License Number State | NV
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10026051
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 235187
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License Number State | LA
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