Individual
MS. LAUREN MARIE PHOENIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
150 N EAGLE CREEK ST. JOES EAST, LEXINGTON, KY 40509
(859) 967-5000
Mailing address
19037 B DRIVE N, MARSHALL, MI 49068
(517) 240-9748
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704164418
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104397649
—
MI
Enumeration date
04/26/2006
Last updated
08/21/2024
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