Provider Demographics
NPI:1295614659
Name:WITT, LAUREN RENAE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENAE
Last Name:WITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 REGENCY POINT PATH
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2356
Mailing Address - Country:US
Mailing Address - Phone:270-576-6475
Mailing Address - Fax:
Practice Address - Street 1:117 WINGATE AVE
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-2257
Practice Address - Country:US
Practice Address - Phone:270-576-6475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program