Individual
LAUREN REBECCA WILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
125 SMITHFIELD LN, EAST STROUDSBURG, PA 18301-8715
(272) 212-3872
Mailing address
2939 OLD BERWICK RD, BLOOMSBURG, PA 17815-3223
(570) 394-2506
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA065189
PA
363A00000X
Physician Assistant
OA006722
PA
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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