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General NPI Number Information
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NPI Number | 1902376999
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Entity Type | Individual
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Provider Name | LAUREN PRANCE CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/03/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2134 DOUGLAS AVE
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City | BREWTON
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State | AL
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Zip | 36426-1155
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Country | US
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Telephone | 251-236-4026
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Fax | 251-270-4257
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Provider Business Mailing Address
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Address Line | 1500 1ST AVE N UNIT 3M135
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City | BIRMINGHAM
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State | AL
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Zip | 35203-1865
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Country | US
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Telephone | 120-554-5509
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Fax | 205-769-1405
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-163141
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License Number State | AL
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