Basic Information
Provider Information
NPI: 1083043517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NULPH
FirstName: LAUREN
MiddleName: ASHLEY
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1126 4TH AVE
Address2:  
City: FORD CITY
State: PA
PostalCode: 162261202
CountryCode: US
TelephoneNumber: 7246649813
FaxNumber:  
Practice Location
Address1: 835 HOSPITAL RD
Address2:  
City: INDIANA
State: PA
PostalCode: 157013629
CountryCode: US
TelephoneNumber: 7243577000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/05/2013
LastUpdateDate: 11/05/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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