Provider Demographics
NPI:1295461671
Name:VAN PELT, LAUREN PAIGE (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:PAIGE
Last Name:VAN PELT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 MURFREESBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-2877
Mailing Address - Country:US
Mailing Address - Phone:615-248-1225
Mailing Address - Fax:
Practice Address - Street 1:133 HOSPITAL DR STE 500
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-4020
Practice Address - Country:US
Practice Address - Phone:615-735-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program