Provider Demographics
NPI:1609680875
Name:BATES, LAUREN MEDL
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MEDL
Last Name:BATES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 SPENCER FARLOW DR UNIT 20
Mailing Address - Street 2:
Mailing Address - City:CAROLINA BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28428-3923
Mailing Address - Country:US
Mailing Address - Phone:910-616-5888
Mailing Address - Fax:
Practice Address - Street 1:625 SPENCER FARLOW DR UNIT 20
Practice Address - Street 2:
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428-3923
Practice Address - Country:US
Practice Address - Phone:910-616-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA144584LB374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula