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General NPI Number Information
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NPI Number | 1821741943
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Entity Type | Individual
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Provider Name | LAUREN ALANA PEVNICK RN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 11645 WILSHIRE BLVD STE 605
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City | LOS ANGELES
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State | CA
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Zip | 90025-6842
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Country | US
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Telephone | 424-644-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 4151 REDWOOD AVE APT 413
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City | LOS ANGELES
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State | CA
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Zip | 90066-5632
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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 | 163WS0121X
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Taxonomy Name | Plastic Surgery Registered Nurse
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License Number | 95250381
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License Number State | CA
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