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 1:109 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-1707
Mailing Address - Country:US
Mailing Address - Phone:615-866-1152
Mailing Address - Fax:615-866-2614
Practice Address - Street 1:109 RIVER ST
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-1707
Practice Address - Country:US
Practice Address - Phone:615-866-1152
Practice Address - Fax:615-866-2614
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant