Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 1-134186 | AL |
NPI | 1003261033 |
---|---|
Provider Name | Kristen Lawhorn |
First Address | Sylacauga, AL 35150-2973 |
Second Address | Sylacauga, AL 35150-2973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2016 |
Last Update Date | 27/04/2016 |