Provider Demographics
NPI:1790969996
Name:AMENEDO, LAUREN ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ANN
Last Name:AMENEDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:165 MAIN ST.
Mailing Address - Street 2:OPEN DOOR FAMILY MEDICAL CENTER
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4702
Mailing Address - Country:US
Mailing Address - Phone:914-941-1263
Mailing Address - Fax:
Practice Address - Street 1:113 BOWMAN AVE,
Practice Address - Street 2:PORTCHESTER MIDDLE SCHOOL
Practice Address - City:PORTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-2808
Practice Address - Country:US
Practice Address - Phone:914-939-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily