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General NPI Number Information
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NPI Number | 1881724110
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Entity Type | Individual
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Provider Name | LAUREN E DRYSDALE APRN
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 166 W BROAD ST SUITE 104
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City | STAMFORD
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State | CT
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Zip | 06902-3661
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Country | US
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Telephone | 203-276-4404
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Fax | 203-276-4405
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Provider Business Mailing Address
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Address Line | 166 W BROAD ST SUITE 104
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City | STAMFORD
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State | CT
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Zip | 06902-3661
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Country | US
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Telephone | 203-276-4404
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Fax | 203-276-4405
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 003371
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F304189
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License Number State | NY
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