Provider Demographics
NPI:1881960136
Name:QUAVE, LAUREN ALENA (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ALENA
Last Name:QUAVE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1810
Mailing Address - Country:US
Mailing Address - Phone:228-865-3200
Mailing Address - Fax:228-575-1660
Practice Address - Street 1:1756 POPPS FERRY RD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2118
Practice Address - Country:US
Practice Address - Phone:228-865-3200
Practice Address - Fax:228-575-1660
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR717738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily