Individual
AMANDA BUSBY LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
9971 AIRPORT BLVD, MOBILE, AL 36608-9525
(251) 660-3500
(251) 660-3501
Mailing address
1071 HILLSIDE CT, MOBILE, AL 36695-9600
(251) 776-0688
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-131518
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-131518
LICENSE NUMBER
AL
Enumeration date
04/10/2018
Last updated
05/08/2020
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