Provider Demographics
NPI:1205535242
Name:BENDER, LAUREN MICHELLE (CRNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MICHELLE
Last Name:BENDER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25379 SUNSET CT N
Mailing Address - Street 2:
Mailing Address - City:LOXLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36551-7418
Mailing Address - Country:US
Mailing Address - Phone:251-434-3660
Mailing Address - Fax:
Practice Address - Street 1:1700 SPRING HILL AVE STE 100
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1416
Practice Address - Country:US
Practice Address - Phone:251-435-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162890363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology