Provider Demographics
NPI:1144874371
Name:AMORELLO, LAUREN JEAN (AGNP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JEAN
Last Name:AMORELLO
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3298 MEADOW RUN CIR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1412
Mailing Address - Country:US
Mailing Address - Phone:978-430-8322
Mailing Address - Fax:
Practice Address - Street 1:11802 TEMPEST HARBOR LOOP
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3821
Practice Address - Country:US
Practice Address - Phone:941-676-3440
Practice Address - Fax:941-303-5552
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003421363L00000X
FL11003421363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner