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NPI Code Detail

MEDICARE: LAUREN NICOLE PROCTER PA-C

MEDICARE: LAUREN NICOLE PROCTER PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1700603685
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN NICOLE PROCTER PA-C
Provider Business Mailing Address
First Line : 5275 THRASHER DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-3565
Country : US
Telephone Number : 317-498-9428
Fax Number :
Provider Business Practice Location Address
First Line : 7150 CLEARVISTA DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1695
Country : US
Telephone Number : 317-621-6262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2024
Last Update Date : 09/23/2024

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Directions to “ LAUREN NICOLE PROCTER PA-C” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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