Provider Demographics
NPI:1922770726
Name:PENDERS, LAUREN (RN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PENDERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4034 WARNER RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NY
Mailing Address - Zip Code:14505-9308
Mailing Address - Country:US
Mailing Address - Phone:315-926-2406
Mailing Address - Fax:
Practice Address - Street 1:4034 WARNER RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NY
Practice Address - Zip Code:14505-9308
Practice Address - Country:US
Practice Address - Phone:315-926-2406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY706756-01163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool