Provider Demographics
NPI:1649683814
Name:CAPEL, LAUREN NICOLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NICOLE
Last Name:CAPEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:EDELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:841 HIGHLAND AVE
Mailing Address - Street 2:BLDG 18 APT 252
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1526
Mailing Address - Country:US
Mailing Address - Phone:484-798-5881
Mailing Address - Fax:610-913-7147
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-4546
Practice Address - Fax:215-481-4629
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA156866363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA156866OtherSTATE BOARD OF MEDICINE