Provider Demographics
NPI:1710313341
Name:BRACKEN, LAUREN COURTNEY (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:COURTNEY
Last Name:BRACKEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:C
Other - Last Name:PAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN-C
Mailing Address - Street 1:989 BURNT TAVERN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-2014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:989 BURNT TAVERN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2014
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-14
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00460900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily