Provider Demographics
NPI:1871967596
Name:BARSAN, LAUREN EMILY (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:EMILY
Last Name:BARSAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ELMS PLANTATION BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-7132
Mailing Address - Country:US
Mailing Address - Phone:843-410-0924
Mailing Address - Fax:843-818-1145
Practice Address - Street 1:2695 ELMS PLANTATION BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-7132
Practice Address - Country:US
Practice Address - Phone:843-410-0924
Practice Address - Fax:843-818-1145
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL2467363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical