Provider Demographics
NPI:1871189936
Name:CANTELE, LAUREN (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:CANTELE
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 WELLS HILL RD
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06039-2201
Mailing Address - Country:US
Mailing Address - Phone:845-505-4102
Mailing Address - Fax:
Practice Address - Street 1:251 CANAAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:CT
Practice Address - Zip Code:06068-1602
Practice Address - Country:US
Practice Address - Phone:860-435-5748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9132363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health