Provider Demographics
NPI:1295318566
Name:BRATSCH, LAUREN KELLE (APRN, AGACNP-BC, FNP)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:KELLE
Last Name:BRATSCH
Suffix:
Gender:F
Credentials:APRN, AGACNP-BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-269-2028
Mailing Address - Fax:
Practice Address - Street 1:1855 KNOX MCRAE DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-5492
Practice Address - Country:US
Practice Address - Phone:321-269-2028
Practice Address - Fax:321-264-0730
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013855363LF0000X
FLRN9468418163W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN7028OtherMEDICARE