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General NPI Number Information
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NPI Number | 1619790219
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Entity Type | Individual
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Provider Name | LAUREN MARIE GIROUX FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1 WILDWOOD MEDICAL CTR
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City | ESSEX
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State | CT
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Zip | 06426-1155
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Country | US
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Telephone | 860-767-0168
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Fax | 860-767-1803
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Provider Business Mailing Address
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Address Line | 1503 HARTFORD RT 85 NEW LONDON TPKE
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City | OAKDALE
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State | CT
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Zip | 06370
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Country | US
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Telephone | 860-303-1859
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 13980
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License Number State | CT
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