| Doctor Name: | LAUREN WILLMER |
| NPI Number: | 1316389323 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2015020492 |
| Business Practice Address: | 1206 Gordon Duckworth Piggott, AR - 724541911 |
| Business Phone Number: | 8705983881 |
| Business Fax Number: | 8705985716 |
| Mailing Address: | 1206 Gordon Duckworth Dr, PIGGOTT |
| State: | AR |
| Postal Code: | 724541911 |
| Phone Number: | 8705983881 |
| Fax Number: | 8705985716 |
| NPI Enumeration Date: | 07/19/2013 |
| NPI Last Update Date: | 02/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2015020492 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |