Basic Information
Provider Information
NPI: 1073285177
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOX
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 18667
Address2:  
City: ERLANGER
State: KY
PostalCode: 410180667
CountryCode: US
TelephoneNumber: 8595723618
FaxNumber: 8595722366
Practice Location
Address1: 1 MEDICAL VILLAGE DR
Address2:  
City: EDGEWOOD
State: KY
PostalCode: 410173403
CountryCode: US
TelephoneNumber: 8593012250
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/28/2021
LastUpdateDate: 03/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X28229963AINN Nursing Service ProvidersRegistered Nurse 
363L00000X71012180AINN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000X3016860KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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