Provider Demographics
NPI:1083848360
Name:DYER, LAUREN CRAFT (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:CRAFT
Last Name:DYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:C
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-716-6008
Mailing Address - Fax:864-716-6732
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 1600
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-716-6008
Practice Address - Fax:864-716-6732
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC99437163W00000X
SC3923363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1472Medicaid
SCAA43088336Medicare PIN