Provider Demographics
NPI:1811247992
Name:CREPEAU, LAUREN HEATON (NNP-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:HEATON
Last Name:CREPEAU
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 GREEN OAK RDG
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-4808
Mailing Address - Country:US
Mailing Address - Phone:404-915-6347
Mailing Address - Fax:
Practice Address - Street 1:5901-B PEACHTREE DUNWOODY ROAD
Practice Address - Street 2:SUITE B-420
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-7156
Practice Address - Country:US
Practice Address - Phone:404-252-9751
Practice Address - Fax:404-255-5783
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN184100363LN0000X, 163W00000X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse