Individual
DOROTHY LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 NEWBERRY DR, PLEASANT GROVE, AL 35127-1626
(205) 915-0633
Mailing address
424 NEWBERRY DR, PLEASANT GROVE, AL 35127-1626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-098446
AL
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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