Basic Information
Provider Information
NPI: 1841853090
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATTISTA
FirstName: LAUREN
MiddleName: MICHELLE
NamePrefix:  
NameSuffix:  
Credential: APN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 416457
Address2:  
City: BOSTON
State: MA
PostalCode: 022416457
CountryCode: US
TelephoneNumber: 8443621735
FaxNumber: 9732907495
Practice Location
Address1: 435 SOUTH ST STE 230A
Address2:  
City: MORRISTOWN
State: NJ
PostalCode: 079606422
CountryCode: US
TelephoneNumber: 9739717507
FaxNumber: 9732907130
Other Information
ProviderEnumerationDate: 04/15/2019
LastUpdateDate: 02/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X26NJ00893600NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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