Provider Demographics
NPI:1144530734
Name:PITEL, LAUREN KELDIE (CRNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KELDIE
Last Name:PITEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 CHELTENHAM AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027
Mailing Address - Country:US
Mailing Address - Phone:215-884-5715
Mailing Address - Fax:215-884-1442
Practice Address - Street 1:1939 W CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1046
Practice Address - Country:US
Practice Address - Phone:215-884-5715
Practice Address - Fax:215-884-1442
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016099363LP0200X
TN172902363LP0200X
SC18742364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP016099OtherSTATE LICENSE
SC18742OtherSTATE LICENSE