Individual
LAUREN B MARCONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, AGNP-C
Contact information
Practice address
4001 E FLETCHER AVE, TAMPA, FL 33613-4808
(813) 821-8038
(813) 974-0483
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
APRN11028837
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
11028837
FL
363LP2300X
Primary Care Nurse Practitioner
APRN11028837
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120291400
—
FL
01
—
408X6
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/09/2023
Last updated
01/27/2025
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