Individual
MRS. LAUREN OURT WIEME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1205 TOWN PARK LN, EVANS, GA 30809-3481
(706) 868-3100
(706) 228-3125
Mailing address
1205 TOWN PARK LN, EVANS, GA 30809-3481
(706) 868-3100
(706) 228-3125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005449
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
704571083A
—
GA
Enumeration date
09/29/2008
Last updated
09/25/2025
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