Provider Demographics
NPI:1770850216
Name:NAVAS, LAUREN JENNIFER (PA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JENNIFER
Last Name:NAVAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 969
Mailing Address - Street 2:
Mailing Address - City:QUECHEE
Mailing Address - State:VT
Mailing Address - Zip Code:05059-0969
Mailing Address - Country:US
Mailing Address - Phone:516-526-9303
Mailing Address - Fax:
Practice Address - Street 1:100 RIVER ST STE 2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2930
Practice Address - Country:US
Practice Address - Phone:802-886-8902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical