Provider Demographics
NPI:1578750733
Name:GAYLORD, LAUREN BELL (RN, CPNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BELL
Last Name:GAYLORD
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37914-3607
Mailing Address - Country:US
Mailing Address - Phone:865-522-8114
Mailing Address - Fax:
Practice Address - Street 1:4529 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-3607
Practice Address - Country:US
Practice Address - Phone:865-522-8114
Practice Address - Fax:865-522-1161
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000155575363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics