MEDICARE: LAUREN VANCE 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
1	363AS0400X	Surgical Physician Assistant	MA059441	PA
2	363AM0700X	Medical Physician Assistant	MA059441	PA

General Provider Information

NPI Number	:	1710498092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN VANCE PA-C

Provider Business Mailing Address
First Line	:	2030 MACKENZIE WAY
Second Line	:	SUITE 400
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066
Country	:	US
Telephone Number	:	724-720-5959
Fax Number	:	724-772-8276

Provider Business Practice Location Address
First Line	:	2030 MACKENZIE WAY
Second Line	:	SUITE 400
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066
Country	:	US
Telephone Number	:	724-720-5959
Fax Number	:	724-772-8276

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

Provider Enumeration Date	:	10/13/2017
Last Update Date	:	12/11/2025

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Directions to “ LAUREN VANCE PA-C” Practice Location

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