Provider Demographics
NPI:1134241441
Name:FOX, LAUREN BETH (NP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:BETH
Last Name:FOX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01096
Mailing Address - Country:US
Mailing Address - Phone:413-535-6022
Mailing Address - Fax:413-268-7338
Practice Address - Street 1:60 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1205
Practice Address - Country:US
Practice Address - Phone:413-535-6022
Practice Address - Fax:413-268-7338
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA119045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0010796Medicare PIN