Provider Demographics
NPI:1043598006
Name:GAYNOR, LAUREN M (APN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:GAYNOR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GAYNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:609-624-9003
Mailing Address - Fax:
Practice Address - Street 1:2041 ROUTE 9 N
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1162
Practice Address - Country:US
Practice Address - Phone:609-624-9003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00533800363LP0200X
DELJ0000264363LP0200X
DELJ0000264/L10040515363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics