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Individual

LAUREN MATHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
411 TOWN PARK BLVD, EVANS, GA 30809-3487
(706) 854-2500
(706) 854-2559
Mailing address
411 TOWN PARK BLVD, EVANS, GA 30809-3487
(706) 854-2500
(706) 854-2559

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
RN214012
GA
363L00000X
Nurse Practitioner
RN214012
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN214012
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003187586D
GA
05
003187586E
GA
05
003187586F
GA
Enumeration date
02/14/2017
Last updated
10/27/2025
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