Provider Demographics
NPI:1750628566
Name:CONNORS, LAUREN JEAN (FNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JEAN
Last Name:CONNORS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1056
Mailing Address - Country:US
Mailing Address - Phone:508-212-2757
Mailing Address - Fax:202-444-3655
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:LUNDER 10
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:508-212-2757
Practice Address - Fax:202-444-3655
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2304483363LF0000X
VA0024170646363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherUSA MANAGED CARE
VA1750628566OtherVIRGINIA PREMIER HEALTH PLAN
VA10106229NOtherOPTIMA HEALTH
VA1750628566Medicaid
VAPAROtherCORVEL
VA-028OtherTRICARE/CHAMPUS
VAPAROtherMULTIPLAN
VA1750628566OtherVIRGINIA PREMIER HEALTH PLAN
VA10106229NOtherOPTIMA HEALTH