Basic Information
Provider Information
NPI: 1427459569
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAY
FirstName: LAUREN
MiddleName: A.
NamePrefix: DR.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8603 QUAIL VISTA DR
Address2:  
City: MISSOURI CITY
State: TX
PostalCode: 774895701
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1500 E WOODROW WILSON AVE
Address2:  
City: JACKSON
State: MS
PostalCode: 392165116
CountryCode: US
TelephoneNumber: 6013624471
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/08/2014
LastUpdateDate: 11/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P0018XE-13614MSY Pharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

No ID Information.


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