Individual
CONNIE JEANINE LASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
300 MEDICAL AVE STE 100, ANDALUSIA, AL 36420-1108
(334) 222-2393
Mailing address
300 MEDICAL AVE STE 100, ANDALUSIA, AL 36420-1108
(334) 222-2393
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-082667
AL
Other
Enumeration date
01/07/2021
Last updated
02/04/2021
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