Lauran E Mejia, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Pecatonica, IL

NPI 1114358264 · NPPES record last updated Apr 5, 2024

Key facts

NPI
1114358264
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
209.0011007 (IL)
Practice address
16129 Kelley Rd
Pecatonica, IL 61063-9449
Phone
(815) 329-3959
NPI assigned
Nov 27, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20131218000946 IL Practitioner - Nurse Practitioner 1759518798 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.0011007 IL Yes

Addresses

Primary practice location

16129 Kelley Rd
Pecatonica, IL 61063-9449

Mailing address

2222 E State St
Suite 209
Rockford, IL 61104-1573
Phone (815) 988-8500

Other providers in Pecatonica, IL

All providers in Pecatonica, IL · Family Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.