Individual
LAUREN LANE BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4517 SOUTHLAKE PKWY, HOOVER, AL 35244-3280
(205) 985-4111
Mailing address
4517 SOUTHLAKE PKWY, HOOVER, AL 35244-3280
(205) 985-4111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-652
AL
363AS0400X
Surgical Physician Assistant
PA-652
AL
Other
Enumeration date
04/24/2009
Last updated
05/18/2023
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