Provider Demographics
NPI:1649624537
Name:DIATTE, LAUREN (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:DIATTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:CARADONNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:590 BENZING RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4139
Mailing Address - Country:US
Mailing Address - Phone:615-988-2340
Mailing Address - Fax:
Practice Address - Street 1:590 BENZING RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4139
Practice Address - Country:US
Practice Address - Phone:615-988-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA150988208000000X
TN63828208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics