Provider Demographics
NPI:1891366795
Name:LETHCO, LAUREN R (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:R
Last Name:LETHCO
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-875-0600
Mailing Address - Fax:843-871-3499
Practice Address - Street 1:507 N LAUREL ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6558
Practice Address - Country:US
Practice Address - Phone:843-875-0600
Practice Address - Fax:843-871-3499
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily