Provider Demographics
NPI:1669002333
Name:MEAUT, LAUREN RENEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEE
Last Name:MEAUT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:RENEE
Other - Last Name:RATCLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9216 MEADOWLARK AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-8325
Mailing Address - Country:US
Mailing Address - Phone:228-217-2027
Mailing Address - Fax:
Practice Address - Street 1:1391 BROAD AVE STE 320
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2419
Practice Address - Country:US
Practice Address - Phone:228-575-1775
Practice Address - Fax:228-575-1770
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily