Provider Demographics
NPI:1619530771
Name:RADER, LAUREN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:RADER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 NICHOLAS COVE RD
Mailing Address - Street 2:
Mailing Address - City:ANACOCO
Mailing Address - State:LA
Mailing Address - Zip Code:71403-3270
Mailing Address - Country:US
Mailing Address - Phone:337-397-0915
Mailing Address - Fax:
Practice Address - Street 1:395 S CAPITOL ST
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3049
Practice Address - Country:US
Practice Address - Phone:318-256-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily