Healthcare Provider Details

I. General information

NPI: 1396852810
Provider Name (Legal Business Name): LURLINE CHANEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25910 CANAL RD SUITE D
ORANGE BEACH AL
36561
US

IV. Provider business mailing address

156 E 15TH AVE
GULF SHORES AL
36542-3516
US

V. Phone/Fax

Practice location:
  • Phone: 251-974-2273
  • Fax: 239-552-7690
Mailing address:
  • Phone: 251-948-4290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9364363
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: