Provider Demographics
NPI:1720336977
Name:COLLIER, LAUREN FABER (PMH-NP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:FABER
Last Name:COLLIER
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CHURCH ST
Mailing Address - Street 2:SUITE 90-104
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1929
Mailing Address - Country:US
Mailing Address - Phone:781-754-6545
Mailing Address - Fax:781-536-0016
Practice Address - Street 1:125 CHURCH ST
Practice Address - Street 2:SUITE 90-104
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1929
Practice Address - Country:US
Practice Address - Phone:781-754-6545
Practice Address - Fax:781-536-0016
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN282781163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110095345AMedicaid
MA110095345AMedicaid