Provider Demographics
NPI:1184975765
Name:FROST, LAURYN LEGACY (LAURYN FROST DNP)
Entity type:Individual
Prefix:DR
First Name:LAURYN
Middle Name:LEGACY
Last Name:FROST
Suffix:
Gender:F
Credentials:LAURYN FROST DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 RAMSDELL LN
Mailing Address - Street 2:
Mailing Address - City:CAPE NEDDICK
Mailing Address - State:ME
Mailing Address - Zip Code:03902-7908
Mailing Address - Country:US
Mailing Address - Phone:207-698-0909
Mailing Address - Fax:
Practice Address - Street 1:RN2364653
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:617-354-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2364653363LP0808X
MECNP121098207Q00000X, 363LF0000X
MDLCM875363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily