| NPI | 1982164620 |
|---|---|
| Former Name | LAUREN NICOLE BACON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP204131) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP204131) |
| 364SR0400X Clinical Nurse Specialist, Rehabilitation (Licence: LA AP204131) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2021-04-09 |