Individual
LAQUEATRECE LASHON WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 731-9701
(205) 297-9411
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-087693
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100133
—
AL
01
—
515-45905
BCBS
AL
Enumeration date
10/29/2007
Last updated
04/24/2017
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