Individual
LAUREN FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
430 EMERALD TRL, BRANDON, MS 39047-6511
(662) 560-3060
Mailing address
2024 E NORTHSIDE DR, JACKSON, MS 39211-6124
(662) 560-3060
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
901412
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
901988
MS
Other
Enumeration date
11/04/2024
Last updated
08/16/2025
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