Provider Demographics
NPI:1124658380
Name:ALBERTINE, LAUREN D (APRN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:D
Last Name:ALBERTINE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:D
Other - Last Name:PRITCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6584 POPLAR AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-0620
Mailing Address - Country:US
Mailing Address - Phone:901-519-4690
Mailing Address - Fax:
Practice Address - Street 1:6584 POPLAR AVE STE 102
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38138-0620
Practice Address - Country:US
Practice Address - Phone:901-519-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27056363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner