Individual
LAUREN ELIZABETH MCINTOSH MCNICHOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
2500 N STATE ST, DEPT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-5160
(601) 984-5085
Mailing address
2500 N STATE ST, DEPT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-6426
(601) 984-6439
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A3486
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01155743
—
MS
Enumeration date
08/16/2010
Last updated
02/14/2014
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