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Individual

LAUREN EVANCZYK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
720 2ND AVE STE 102, BOWLING GREEN, KY 42101-1778
(502) 588-3650
(502) 588-7852
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3009656
KY
363LF0000X
Family Nurse Practitioner
71006895A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201336210
IN
01
3009656
STATE LICENSE
KY
05
7100391180
KY
Enumeration date
08/19/2015
Last updated
05/23/2022
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