Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | SP019679 | PA |
N | 363LA2100X | Nurse Practitioner - Acute Care | SP019679 | PA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | SP019679 | PA |
NPI | 1013488147 |
---|---|
Provider Name | Mrs. Lauren Michelle Hecker |
First Address | Norristown, PA 19403-4106 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2018 |
Last Update Date | 16/12/2018 |