Provider Demographics
NPI:1144688151
Name:MUNOZ, LAUREN RENEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEE
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 SPRINGBANK LN STE E
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3379
Mailing Address - Country:US
Mailing Address - Phone:704-774-3044
Mailing Address - Fax:704-774-3045
Practice Address - Street 1:3125 SPRINGBANK LN STE E
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3379
Practice Address - Country:US
Practice Address - Phone:704-774-3044
Practice Address - Fax:704-774-3045
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20858363L00000X
NC5010276363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner