Provider Demographics
NPI:1013626902
Name:HALE, LAUREN (CPM, CDEM)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:CPM, CDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 E WAITS RD
Mailing Address - Street 2:
Mailing Address - City:KENDALLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46755-3370
Mailing Address - Country:US
Mailing Address - Phone:260-438-6716
Mailing Address - Fax:
Practice Address - Street 1:4126 E NORTH COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUNTERTOWN
Practice Address - State:IN
Practice Address - Zip Code:46748-9287
Practice Address - Country:US
Practice Address - Phone:260-450-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN90000018A176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife