Provider Demographics
NPI:1215185954
Name:HERRMANN, LAUREN PATRICIA GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:PATRICIA GRANT
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:PATRICIA
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 CENTRAL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-1450
Mailing Address - Country:US
Mailing Address - Phone:502-588-8720
Mailing Address - Fax:502-588-8721
Practice Address - Street 1:215 CENTRAL AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-1450
Practice Address - Country:US
Practice Address - Phone:502-588-8720
Practice Address - Fax:502-588-8721
Is Sole Proprietor?:No
Enumeration Date:2008-09-07
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY55283207Q00000X
IN01072327207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine