Individual
LAUREN CANADA-SMITH VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
239 STATION ST, JACKSONVILLE, NC 28546-6304
(910) 353-0819
Mailing address
239 STATION ST, JACKSONVILLE, NC 28546-6304
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-07496
NC
Other
Enumeration date
08/25/2017
Last updated
03/23/2022
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