Individual
ANN BOURGEOIS LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
101 BOB WALLACE AVE SW STE E, HUNTSVILLE, AL 35801-3843
(256) 539-5339
(256) 536-5111
Mailing address
1321 HUNTSVILLE HWY, FAYETTEVILLE, TN 37334-3603
(931) 297-2201
(931) 297-2206
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-035725
AL
363LF0000X
Family Nurse Practitioner
APN0000019106
TN
Other
Enumeration date
06/18/2013
Last updated
03/28/2018
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