Provider Demographics
NPI:1821553959
Name:MARTIN, LAUREN LAVEE (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LAVEE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WHITE BRIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1492
Mailing Address - Country:US
Mailing Address - Phone:615-354-2460
Mailing Address - Fax:615-661-2425
Practice Address - Street 1:1617 WILLIAMS DR STE 200
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3287
Practice Address - Country:US
Practice Address - Phone:615-890-5484
Practice Address - Fax:615-890-7924
Is Sole Proprietor?:No
Enumeration Date:2019-02-03
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25459363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNNAOtherNOT APPLICABLE