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General NPI Number Information
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NPI Number | 1639645658
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Entity Type | Individual
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Provider Name | LAUREN ELISE PEEK TRAVILLION FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 1800 FARM ROAD 195
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City | PARIS
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State | TX
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Zip | 75462-2806
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Country | US
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Telephone | 903-739-7920
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Fax | 903-739-7925
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Provider Business Mailing Address
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Address Line | 1800 FARM ROAD 195
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City | PARIS
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State | TX
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Zip | 75462-2806
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Country | US
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Telephone | 903-739-7920
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Fax | 903-739-7925
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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 | AP139299
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License Number State | TX
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