Provider Demographics
NPI:1639696586
Name:ENGLE, LAUREN RENEA (PHARMD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEA
Last Name:ENGLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX R
Mailing Address - Street 2:
Mailing Address - City:LOCKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:65682-0372
Mailing Address - Country:US
Mailing Address - Phone:417-232-4721
Mailing Address - Fax:417-232-5099
Practice Address - Street 1:725 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOCKWOOD
Practice Address - State:MO
Practice Address - Zip Code:65682-9501
Practice Address - Country:US
Practice Address - Phone:417-232-4721
Practice Address - Fax:417-232-5099
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017026029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist