Provider Demographics
NPI:1013774512
Name:PONCE, LAUREN CAROLINE (RN)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:CAROLINE
Last Name:PONCE
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Gender:
Credentials:RN
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Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:14546 OLD SAINT AUGUSTINE RD STE 305&311
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5468
Practice Address - Country:US
Practice Address - Phone:904-260-2255
Practice Address - Fax:855-618-2164
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2025-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL9471430163W00000X
FLAPRN11039306363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse