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General NPI Number Information
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NPI Number | 1316486400
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Entity Type | Individual
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Provider Name | LAUREN HEEKE CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 273 WINTON BLOUNT LOOP
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City | MONTGOMERY
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State | AL
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Zip | 36117-3507
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Country | US
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Telephone | 342-801-5003
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Fax | 334-280-1600
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Provider Business Mailing Address
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Address Line | PO BOX 241587
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City | MONTGOMERY
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State | AL
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Zip | 36124-1587
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Country | US
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Telephone | 334-280-1500
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Fax | 334-280-1600
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-149412
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-149412
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License Number State | AL
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