Provider Demographics
NPI:1467160598
Name:DEWITT, LAUREN LEVINER (RN)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:LEVINER
Last Name:DEWITT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1179 CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:ELLERBE
Mailing Address - State:NC
Mailing Address - Zip Code:28338-8407
Mailing Address - Country:US
Mailing Address - Phone:910-331-1620
Mailing Address - Fax:
Practice Address - Street 1:1179 CRAWFORD RD
Practice Address - Street 2:
Practice Address - City:ELLERBE
Practice Address - State:NC
Practice Address - Zip Code:28338-8407
Practice Address - Country:US
Practice Address - Phone:910-331-1620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC233516163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse