Individual
MRS. LAUREN AMBROSIA DALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2204 PAVILION DR, SUITE 108, KINGSPORT, TN 37660-4657
(423) 392-6100
(423) 392-6159
Mailing address
2204 PAVILION DR, SUITE 108, KINGSPORT, TN 37660-4657
(423) 392-6100
(423) 392-6159
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000014653
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265763668
—
VA
05
—
1519308
—
TN
01
—
4299418
BCBS TENNESSEE
TN
Enumeration date
01/25/2010
Last updated
04/19/2012
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