Provider Demographics
NPI:1265147029
Name:WANAT, LAUREN L
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:L
Last Name:WANAT
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 1:948 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOLLANSBEE
Mailing Address - State:WV
Mailing Address - Zip Code:26037
Mailing Address - Country:US
Mailing Address - Phone:304-527-3410
Mailing Address - Fax:304-527-4278
Practice Address - Street 1:948 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOLLANSBEE
Practice Address - State:WV
Practice Address - Zip Code:26037
Practice Address - Country:US
Practice Address - Phone:304-527-3410
Practice Address - Fax:304-527-4278
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker