MEDICARE: MRS. LAUREN ENRIQUEZ FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	45058	GA
2	363LF0000X	Family Nurse Practitioner	F10210959	GA

General Provider Information

NPI Number	:	1063176972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAUREN ENRIQUEZ FNP

Provider Business Mailing Address
First Line	:	750 BENTWOOD TRCE
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4144
Country	:	US
Telephone Number	:	407-808-2292
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CONCOURSE PKWY STE 620
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-5534
Country	:	US
Telephone Number	:	678-812-2212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	10/09/2025

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