Provider Demographics
NPI:1558653550
Name:EAGAN, LAUREN E (CPNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:EAGAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:A
Other - Last Name:ELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2141 K ST NW
Mailing Address - Street 2:SUITE 401
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1810
Mailing Address - Country:US
Mailing Address - Phone:202-833-4543
Mailing Address - Fax:
Practice Address - Street 1:2141 K ST NW
Practice Address - Street 2:SUITE 401
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1810
Practice Address - Country:US
Practice Address - Phone:202-833-4543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1015418363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics