Provider Demographics
NPI:1912445461
Name:BRANNON, LAUREN BERL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BERL
Last Name:BRANNON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15238
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-1938
Mailing Address - Country:US
Mailing Address - Phone:912-650-5480
Mailing Address - Fax:
Practice Address - Street 1:16 KEMMERLIN LANE, SUITE A
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-2709
Practice Address - Country:US
Practice Address - Phone:843-524-2002
Practice Address - Fax:843-524-3522
Is Sole Proprietor?:No
Enumeration Date:2017-02-05
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN225594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily