Individual
LAWANDA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 BRIDGEFIELD CIR, HATTIESBURG, MS 39402-8692
(601) 336-9450
Mailing address
12 BRIDGEFIELD CIR, HATTIESBURG, MS 39402-8692
(601) 336-9450
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P325935
MS
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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