Provider Demographics
NPI:1811517329
Name:FITZHARRIS, LAUREN NICOLE (FNP-BC, CNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:FITZHARRIS
Suffix:
Gender:F
Credentials:FNP-BC, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 ANDREW AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-3157
Mailing Address - Country:US
Mailing Address - Phone:774-777-6200
Mailing Address - Fax:774-777-6260
Practice Address - Street 1:109 ANDREW AVE STE 101
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-3157
Practice Address - Country:US
Practice Address - Phone:774-777-6200
Practice Address - Fax:774-777-6260
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2358747163W00000X, 363LF0000X
GARN255854163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse