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General NPI Number Information
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NPI Number | 1508523424
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH PEARSON
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Gender | Female
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Dates
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Enumeration Date | 11/27/2021
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 516 W OAKLAND AVE STE 101
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City | JOHNSON CITY
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State | TN
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Zip | 37604-1677
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Country | US
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Telephone | 423-888-0399
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Fax |
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Provider Business Mailing Address
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Address Line | 1404 CRESCENT DR
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City | KINGSPORT
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State | TN
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Zip | 37664-2036
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Country | US
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Telephone | 601-540-0872
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 201402144RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 202212408NP-PP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 32177
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License Number State | TN
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