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General NPI Number Information
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NPI Number | 1447892187
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Entity Type | Individual
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Provider Name | LAUREN NICOLE URIE PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2215 TOBACCO RD STE F
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City | AUGUSTA
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State | GA
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Zip | 30906-8112
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Country | US
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Telephone | 706-396-1140
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Fax |
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Provider Business Mailing Address
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Address Line | 542 JENSEN LN
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City | AUGUSTA
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State | GA
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Zip | 30909-0091
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Country | US
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Telephone | 724-880-5377
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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 | 024213-01
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License Number State | NY
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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 | 024213
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 12585
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License Number State | GA
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