Organization
REBECCA LAUREN APRN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA ANN LAUREN MSN, APRN, PMHNP-BC (APRN)
(813) 453-7931
Entity
Organization
Contact information
Practice address
5512 18TH ST NE, SAINT PETERSBURG, FL 33703-1731
(813) 453-7931
Mailing address
5512 18TH ST NE, SAINT PETERSBURG, FL 33703-1731
(813) 453-7931
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ATN556765
—
FL
Enumeration date
05/30/2019
Last updated
05/30/2019
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