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General NPI Number Information
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NPI Number | 1568247773
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Entity Type | Individual
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Provider Name | LAUREN DAVENPORT NP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 425 N WENDOVER RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1064
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Country | US
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Telephone | 704-817-8230
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 BIG OAK DR
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City | CHARLOTTE
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State | NC
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Zip | 28210-6420
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Country | US
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Telephone |
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 253259
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5020877
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License Number State | NC
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