Provider Demographics
NPI:1366138075
Name:HEATH, LAUREN (MSN, RN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HEATH
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 BURNT HILL RD
Mailing Address - Street 2:
Mailing Address - City:CADYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12918-2015
Mailing Address - Country:US
Mailing Address - Phone:518-570-3444
Mailing Address - Fax:
Practice Address - Street 1:710 BURNT HILL RD
Practice Address - Street 2:
Practice Address - City:CADYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12918-2015
Practice Address - Country:US
Practice Address - Phone:518-570-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY716646163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health