Provider Demographics
NPI:1164549473
Name:BIRCH, LAUREN B (RNC, WHCNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:B
Last Name:BIRCH
Suffix:
Gender:F
Credentials:RNC, WHCNP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:B
Other - Last Name:WHITENACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNC, WHCNP
Mailing Address - Street 1:1900 W CHANDLER BLVD
Mailing Address - Street 2:15-391
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-8632
Mailing Address - Country:US
Mailing Address - Phone:480-821-3600
Mailing Address - Fax:480-857-2667
Practice Address - Street 1:920 E WILLIAMS FIELD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4880
Practice Address - Country:US
Practice Address - Phone:480-821-3600
Practice Address - Fax:480-857-2667
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN143116163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP2644OtherADV PRACTITIONER