Provider Demographics
NPI:1164937959
Name:COREY, LAUREN MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:COREY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HAZEL LN STE 200
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1249
Mailing Address - Country:US
Mailing Address - Phone:412-749-6938
Mailing Address - Fax:
Practice Address - Street 1:100 HAZEL LN STE 200
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1249
Practice Address - Country:US
Practice Address - Phone:412-749-6938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-03
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103456980Medicaid
14206276OtherCAQH