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General NPI Number Information
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NPI Number | 1942197165
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Entity Type | Individual
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Provider Name | LAUREN CONSTANTINO RN
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Gender | Female
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 4300 PINE FOREST RD APT 4322
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City | AUGUSTA
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State | GA
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Zip | 30909-0678
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Country | US
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Telephone | 404-543-2259
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 PINE FOREST RD APT 4322
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City | AUGUSTA
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State | GA
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Zip | 30909-0678
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Country | US
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Telephone | 404-543-2259
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN269979
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License Number State | GA
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