Provider Demographics
NPI:1689214033
Name:NATES, LAUREN RUDD (MSN, APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:RUDD
Last Name:NATES
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 LAURELHURST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-3825
Mailing Address - Country:US
Mailing Address - Phone:803-733-5969
Mailing Address - Fax:803-753-5591
Practice Address - Street 1:338 E COLUMBIA AVE STE B
Practice Address - Street 2:
Practice Address - City:BATESBURG LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-9285
Practice Address - Country:US
Practice Address - Phone:803-532-1580
Practice Address - Fax:803-532-3832
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN291808363LF0000X
SC25060363LF0000X
SCL-301563163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant