Basic Information
| Provider Information | |||||||||
| NPI: | 1073572970 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOND | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | BRIEN | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7580 BUCKINGHAM BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210763210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107295100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 125 SHOREWAY DR STE 120 | ||||||||
| Address2: | |||||||||
| City: | QUEENSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216581681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108274001 | ||||||||
| FaxNumber: | 4108274333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 08/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R176421 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 411779401 | 05 | MD | MEDICAID | 895749-01 | 01 | MD | CAREFIRST MD RENDERING | OTHER | 214055 | 01 | MD | EHP/PRIORITY PARTNERS | OTHER | 7291171 | 01 | MD | AETNA PPO | OTHER | 7605-0086 | 01 | MD | CAREFIRST BLUECHOICE | OTHER | P00726149 | 01 | MD | RAILROAD MEDICARE | OTHER | 6293428 | 01 | MD | AETNA HMO | OTHER |