Provider Demographics
NPI:1013587674
Name:MCDONOUGH, LAUREN KATHERINE (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:KATHERINE
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8300 BRASS MILL LN APT 207
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-2000
Mailing Address - Country:US
Mailing Address - Phone:703-785-2802
Mailing Address - Fax:
Practice Address - Street 1:2991 CROUSE LN
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8833
Practice Address - Country:US
Practice Address - Phone:336-586-0994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant