Provider Demographics
NPI:1881944007
Name:ZIEGLER, LAUREN MARIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MARIE
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:MARIE
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:700 S. HENDERSON ROAD
Mailing Address - Street 2:SUITE #308-C
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406
Mailing Address - Country:US
Mailing Address - Phone:610-337-3111
Mailing Address - Fax:610-337-3506
Practice Address - Street 1:700 E TOWNSHIP LINE RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-5733
Practice Address - Country:US
Practice Address - Phone:484-458-1000
Practice Address - Fax:484-458-1001
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2018-07-27
Deactivation Date:2018-07-24
Deactivation Code:
Reactivation Date:2018-07-27
Provider Licenses
StateLicense IDTaxonomies
PAMA055619363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA275821SSSMedicare PIN