Provider Demographics
NPI:1336796564
Name:OPPENHEIM, LAUREN ELISE (CRNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISE
Last Name:OPPENHEIM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 WALNUT STREET
Mailing Address - Street 2:11 FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-829-2345
Mailing Address - Fax:215-829-3365
Practice Address - Street 1:919 CONESTOGA RD STE 104
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1352
Practice Address - Country:US
Practice Address - Phone:610-525-6400
Practice Address - Fax:610-525-1801
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020085363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health