Provider Demographics
NPI:1336506872
Name:LEWELLEN, LAUREN ALISSA (APRN, FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ALISSA
Last Name:LEWELLEN
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Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:12615 TAYLORSVILLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-4452
Practice Address - Country:US
Practice Address - Phone:502-261-1595
Practice Address - Fax:602-261-1590
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2021-01-19
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Provider Licenses
StateLicense IDTaxonomies
KY3010074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily