Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP129330 | TX |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP129330 | TX |
NPI | 1194190165 |
---|---|
Provider Name | Lauren Ashley Bereuter |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2015 |
Last Update Date | 14/11/2019 |