Provider Demographics
NPI:1679143911
Name:WARZNIE, LAUREN MICHELLE (PA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MICHELLE
Last Name:WARZNIE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1098 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-1451
Mailing Address - Country:US
Mailing Address - Phone:248-202-8994
Mailing Address - Fax:
Practice Address - Street 1:1098 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1451
Practice Address - Country:US
Practice Address - Phone:248-202-8994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant