Provider Demographics
NPI:1396315354
Name:ALCORN, LAUREN MICHELLE (PMHNP-BC, MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MICHELLE
Last Name:ALCORN
Suffix:
Gender:F
Credentials:PMHNP-BC, MSN, RN
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MICHELLE
Other - Last Name:PINEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7440 N SHADELAND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2027
Mailing Address - Country:US
Mailing Address - Phone:765-491-1026
Mailing Address - Fax:888-400-7207
Practice Address - Street 1:7440 N SHADELAND AVE STE 204
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2027
Practice Address - Country:US
Practice Address - Phone:317-603-4152
Practice Address - Fax:888-400-7207
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011258A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health