Provider Demographics
NPI:1841533890
Name:FREEMAN, LAUREN ETZ (CPNP, IBCLC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ETZ
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CPNP, IBCLC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:ETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7113 THREE CHOPT ROAD, SUITE 101
Mailing Address - Street 2:PEDIATRIC ASSOCIATES OF RICHMOND, INC.
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226
Mailing Address - Country:US
Mailing Address - Phone:804-288-3525
Mailing Address - Fax:804-673-6432
Practice Address - Street 1:7113 THREE CHOPT ROAD, SUITE 101
Practice Address - Street 2:PEDIATRIC ASSOCIATES OF RICHMOND, INC.
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226
Practice Address - Country:US
Practice Address - Phone:804-288-3525
Practice Address - Fax:804-673-6432
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170751363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics