1144528928 NPI number — MRS. LAUREN ASHLEY GARMON C.P.N.P.

Table of content: MRS. LAUREN ASHLEY GARMON C.P.N.P. (NPI 1144528928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144528928 NPI number — MRS. LAUREN ASHLEY GARMON C.P.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARMON
Provider First Name:
LAUREN
Provider Middle Name:
ASHLEY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
C.P.N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCLEES
Provider Other First Name:
LAUREN
Provider Other Middle Name:
ASHLEY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
C.P.N.P.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144528928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
595 HURRICANE SHOALS ROAD NW
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LAWRENCEVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-995-0823
Provider Business Mailing Address Fax Number:
770-995-7018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
595 HURRICANE SHOALS ROAD NW
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-995-0823
Provider Business Practice Location Address Fax Number:
770-995-7018
Provider Enumeration Date:
03/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  RN192244 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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