Provider Demographics
NPI:1922446210
Name:WILLIAMS, LAUREN MACKENZIE (NP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MACKENZIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 LEWIS HARGETT CIR STE 260
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3506
Mailing Address - Country:US
Mailing Address - Phone:859-338-0466
Mailing Address - Fax:859-294-0802
Practice Address - Street 1:448 LEWIS HARGETT CIR STE 260
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3506
Practice Address - Country:US
Practice Address - Phone:859-338-0466
Practice Address - Fax:859-294-0802
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010590363LP0808X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100459680Medicaid
KY7100459680Medicaid
IN000000835377OtherANTHEM
KY7100459680Medicaid