Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 24719 | SC |
N | 363LN0000X | Nurse Practitioner - Neonatal | 25632 | TN |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 25632 | TN |
NPI | 1225598923 |
---|---|
Provider Name | Lauren Mull |
First Address | Johns Island, SC 29455-9022 |
Second Address | Columbia, SC 29203-6863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2019 |
Last Update Date | 11/11/2021 |