Provider Demographics
NPI:1821576174
Name:BACHMAN, LAUREN NICOLE (DNP, AGNP-BC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:NICOLE
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:DNP, AGNP-BC
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:RUEGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, AGNP-BC
Mailing Address - Street 1:2516 W LAREDO LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-6002
Mailing Address - Country:US
Mailing Address - Phone:507-251-6749
Mailing Address - Fax:
Practice Address - Street 1:16952 W BELL RD STE E-304
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8951
Practice Address - Country:US
Practice Address - Phone:507-251-6749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11390363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AP11390OtherSTATE LICENSE