Provider Demographics
NPI:1033593892
Name:POLLOCK, LAUREN MARY (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARY
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8908 HIGHTAIL DR
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-2062
Mailing Address - Country:US
Mailing Address - Phone:203-331-2278
Mailing Address - Fax:
Practice Address - Street 1:7801 MISSION CENTER CT STE 250
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1314
Practice Address - Country:US
Practice Address - Phone:619-738-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-11
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2283285363LF0000X, 163W00000X
CA95003019363LF0000X
CA95065055163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse