Individual
MRS. LAUREN S AYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1410 JEFFERSON ST, LAUREL, MS 39440-4243
(601) 425-7522
(601) 425-7524
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R881219
MS
363LF0000X
Family Nurse Practitioner
Primary
R881219
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03101303
—
MS
Enumeration date
03/01/2012
Last updated
06/29/2015
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