Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1-137067 | AL |
NPI | 1003354713 |
---|---|
Provider Name | Lauren Marie Mcminn |
First Address | Mobile, AL 36607-2301 |
Second Address | Mobile, AL 36607-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2017 |
Last Update Date | 26/11/2019 |