Provider Demographics
NPI:1043739642
Name:PLEIS, LAUREN LYNN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:LYNN
Last Name:PLEIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:LYNN
Other - Last Name:GRABOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:8019 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-2786
Mailing Address - Country:US
Mailing Address - Phone:215-332-1300
Mailing Address - Fax:215-332-5219
Practice Address - Street 1:8019 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2786
Practice Address - Country:US
Practice Address - Phone:215-332-1300
Practice Address - Fax:215-332-5219
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily