Provider Demographics
NPI:1659577930
Name:WILLIAMS, LAUREN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CLARIDGE CT N
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8351
Mailing Address - Country:US
Mailing Address - Phone:386-866-9393
Mailing Address - Fax:386-309-9930
Practice Address - Street 1:1415 NW 23RD AVE
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-1976
Practice Address - Country:US
Practice Address - Phone:352-493-9393
Practice Address - Fax:352-332-6093
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9169564363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308581300Medicaid