MEDICARE: CARLEY LAKENN INMON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	00826	MS
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1447923651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLEY LAKENN INMON

Provider Business Mailing Address
First Line	:	1313 SCHILLINGER RD S APT 3114
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-8998
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 SCHILLINGER RD S APT 3114
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-8998
Country	:	US
Telephone Number	:	601-554-6614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	11/14/2024

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Directions to “ CARLEY LAKENN INMON ” Practice Location

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