Provider Demographics
NPI:1689332090
Name:HARRIS, LAUREN DIGGS (AGPCNP-BC)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:DIGGS
Last Name:HARRIS
Suffix:
Gender:
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 LONG LAKE DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1240
Mailing Address - Country:US
Mailing Address - Phone:410-816-6450
Mailing Address - Fax:
Practice Address - Street 1:8601 WESTWOOD CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2217
Practice Address - Country:US
Practice Address - Phone:703-712-7183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210155163W00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty