Provider Demographics
NPI:1225550320
Name:DIEBEL, LAUREN J (CNS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:J
Last Name:DIEBEL
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 N MO PAC EXPY STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3282
Mailing Address - Country:US
Mailing Address - Phone:512-458-8400
Mailing Address - Fax:512-458-8593
Practice Address - Street 1:6500 N MO PAC EXPY STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3282
Practice Address - Country:US
Practice Address - Phone:512-458-8400
Practice Address - Fax:512-458-8593
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX882533163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse