Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN168252 | GA |
NPI | 1053738054 |
---|---|
Provider Name | Mrs. Lauren Rachel Lambeth |
First Address | Macon, GA 31217-3874 |
Second Address | Macon, GA 31217-3874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 27/03/2014 |