Provider Demographics
NPI:1093307977
Name:ILGENFRITZ, LAUREN BEXLEY (FNP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:BEXLEY
Last Name:ILGENFRITZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:BEXLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4483 ORLEANS DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6023
Mailing Address - Country:US
Mailing Address - Phone:404-704-4999
Mailing Address - Fax:
Practice Address - Street 1:993 JOHNSON FY RD NE STE 210
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-256-1727
Practice Address - Fax:404-252-3591
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN248660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily