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Individual

LAUREN PETRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
550 N UNIVERSITY BLVD, SUITE 3005, INDIANAPOLIS, IN 46202-5149
(317) 944-2167
Mailing address
17254 140TH AVE, RENTON, WA 98058
(425) 226-7614
(509) 241-7628

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28203630A
IN
363LF0000X
Family Nurse Practitioner
71004087A
IN
363LF0000X
Family Nurse Practitioner
Primary
AP60260385
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201086890
IN
Enumeration date
08/08/2012
Last updated
04/30/2021
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