Provider Demographics
NPI:1740521681
Name:WOOTEN, LAUREN ELIZABETH (WHNP-BC)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:WOOTEN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:HANCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:1050 RIVER OAKS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9564
Mailing Address - Country:US
Mailing Address - Phone:601-420-0134
Mailing Address - Fax:601-420-0547
Practice Address - Street 1:1050 RIVER OAKS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9564
Practice Address - Country:US
Practice Address - Phone:601-420-0134
Practice Address - Fax:601-420-0547
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR872482363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health