Individual
MISS LAUREN WELLS QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11200 GOVERNOR MANLY WAY STE 309, RALEIGH, NC 27614-7375
(919) 562-9410
(919) 562-2948
Mailing address
11200 GOVERNOR MANLY WAY STE 309, RALEIGH, NC 27614-7375
(919) 819-6171
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/08/2019
Last updated
09/16/2019
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