Provider Demographics
NPI:1366827529
Name:DRY, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DRY
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 1:850 LITTLE PINE RD
Mailing Address - Street 2:
Mailing Address - City:ENNICE
Mailing Address - State:NC
Mailing Address - Zip Code:28623-9074
Mailing Address - Country:US
Mailing Address - Phone:704-840-6061
Mailing Address - Fax:
Practice Address - Street 1:119 WELCH RD
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-5274
Practice Address - Country:US
Practice Address - Phone:336-719-7138
Practice Address - Fax:367-789-8167
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007827363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1366827529OtherBCBS