Provider Demographics
NPI:1205471414
Name:KUIPER, LAUREN EMILY
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:EMILY
Last Name:KUIPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 YAKIMA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5309
Mailing Address - Country:US
Mailing Address - Phone:253-363-8700
Mailing Address - Fax:253-272-0419
Practice Address - Street 1:1708 YAKIMA AVE STE 300
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5309
Practice Address - Country:US
Practice Address - Phone:253-363-8700
Practice Address - Fax:253-272-0419
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61095106363L00000X, 363LG0600X
TN26772363LA2100X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine