Provider Demographics
NPI:1174869747
Name:PEARCE, LAUREN BARTLING (CPNP-AC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:BARTLING
Last Name:PEARCE
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:PRENTICE
Other - Last Name:BARTLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-1000
Mailing Address - Fax:
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:888-815-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-29
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN191795163W00000X
GA209764163W00000X
TN17396363LP0222X
MS902874363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No163W00000XNursing Service ProvidersRegistered Nurse