Provider Demographics
NPI:1356072128
Name:WITTWER, LAUREN HILLAM (DNP, CPNP-PC, RN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:HILLAM
Last Name:WITTWER
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 GLENSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-9640
Mailing Address - Country:US
Mailing Address - Phone:801-361-0301
Mailing Address - Fax:
Practice Address - Street 1:500 HOLLY SPRINGS RD STE 101
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-6204
Practice Address - Country:US
Practice Address - Phone:919-701-8057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016406363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics