Provider Demographics
NPI:1255219523
Name:STALEY, LAUREN JOSEPHINE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JOSEPHINE
Last Name:STALEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 STAGE HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4037
Mailing Address - Country:US
Mailing Address - Phone:901-937-3200
Mailing Address - Fax:
Practice Address - Street 1:8010 STAGE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-4037
Practice Address - Country:US
Practice Address - Phone:901-937-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054922225100000X
TN16839225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist