Provider Demographics
NPI:1891288387
Name:HOLLINGSWORTH, LAUREN LEE (LPN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LEE
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KATSURA CT
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-2611
Mailing Address - Country:US
Mailing Address - Phone:585-545-5672
Mailing Address - Fax:
Practice Address - Street 1:11 KATSURA CT
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2611
Practice Address - Country:US
Practice Address - Phone:585-545-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320340-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY320340-1OtherNURSING LICENSE