Individual
AN N LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1340 BROAD AVE STE 440, GULFPORT, MS 39501-2460
(228) 867-4855
Mailing address
1340 BROAD AVE STE 440, GULFPORT, MS 39501-2460
(228) 867-4855
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902822
MS
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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