1043749112 NPI number — LAUREN EISENHAUER MCMARLIN DNP

Table of content: LAUREN EISENHAUER MCMARLIN DNP (NPI 1043749112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043749112 NPI number — LAUREN EISENHAUER MCMARLIN DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCMARLIN
Provider First Name:
LAUREN
Provider Middle Name:
EISENHAUER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EISENHAUER
Provider Other First Name:
LAUREN
Provider Other Middle Name:
RAE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043749112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 DENOW ROAD
Provider Second Line Business Mailing Address:
E2
Provider Business Mailing Address City Name:
PENNINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-775-9545
Provider Business Mailing Address Fax Number:
609-775-9545

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 DENOW ROAD
Provider Second Line Business Practice Location Address:
E2
Provider Business Practice Location Address City Name:
PENNINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-775-9545
Provider Business Practice Location Address Fax Number:
609-775-9545
Provider Enumeration Date:
06/12/2017

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: 363LF0000X , with the licence number:  26NJ00736300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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