Individual
MRS. LAUREN NICHOLE VANDERBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3451 GOODMAN RD E STE 115, SOUTHAVEN, MS 38672-9304
(662) 890-5555
(662) 890-8899
Mailing address
3451 GOODMAN E RD 115, SOUTHAVEN, MS 38672-9304
(662) 890-5555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000022895
TN
Other
Enumeration date
04/28/2017
Last updated
02/21/2020
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