Provider Demographics
NPI:1649991373
Name:TONGS, LAUREN E
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:TONGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BALTIMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4987
Mailing Address - Country:US
Mailing Address - Phone:325-716-0559
Mailing Address - Fax:
Practice Address - Street 1:275 BALTIMORE BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-4987
Practice Address - Country:US
Practice Address - Phone:325-716-0559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR250283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily