Individual
LAURA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1062
Mailing address
209 CABO LOOP, MYRTLE BEACH, SC 29588-7658
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4444
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2120
—
SC
Enumeration date
01/27/2011
Last updated
06/26/2013
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