Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lauren Wallis

Individual provider Family Nurse Practitioner · NPI 1679445696

Lauren Wallis is a Nurse Practitioner in Binghamton, New York. Qualified in 2025, 1 year ago. Practices with Our Lady of Lourdes Memorial Hospital Inc, a 249-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025
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Practice location Address checks out

169 Riverside Dr
Binghamton, NY 13905-4246
Phone: (570) 904-1213
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 357599 (NY)

Record details

NPI number1679445696
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 19, 2025
Last updated in NPPESSeptember 19, 2025
Certification dateSeptember 19, 2025
Mailing address31 Midwood Dr, Binghamton, NY 13903-1921

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Our Lady Of Lourdes Memorial Hospital Inc — 249 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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