Provider Demographics
NPI:1811326200
Name:TRAVELLER, LAUREN (APRN)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:TRAVELLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 E 110 N
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-9005
Mailing Address - Country:US
Mailing Address - Phone:435-705-8783
Mailing Address - Fax:
Practice Address - Street 1:6592 N DECATUR BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1037
Practice Address - Country:US
Practice Address - Phone:702-396-4993
Practice Address - Fax:702-636-4990
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001595363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily