Individual
LAWANDA S FANTROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 SPRING HILL AVE STE 100, MOBILE, AL 36604-1416
(251) 435-1200
Mailing address
4361 TERRACE DR, MOSS POINT, MS 39563-5635
(228) 235-6015
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-122621
AL
363LA2200X
Adult Health Nurse Practitioner
20629
MN
Other
Enumeration date
02/27/2019
Last updated
02/29/2024
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