Lauren Marie Neisen, PHARMD – Pharmacist

Key facts

NPI: 1295573285
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 051306384 (IL)
Practice address: 3700 Broadway St
Quincy, IL 62305-2822
Phone: (217) 224-7555
NPI assigned: Jul 16, 2024
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Pharmacy

State licenses

License	State	Type	Specialty
051306384	IL	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	051306384	IL	Yes

Addresses

Primary practice location

3700 Broadway St
Quincy, IL 62305-2822

Mailing address

3700 Broadway St
Quincy, IL 62305-2822

Other names

Lauren Marie White Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 16, 2024.

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1295573285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623052822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623052822",
            "telephone_number": "217-224-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISEN",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051306384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "WHITE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Quincy, IL

All providers in Quincy, IL · Pharmacist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.