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Lauren Nichole Vanderburg

Nurse Practitioner in Southaven, MS. Individual provider (NPI-1).

NPI number1669907424
StatusActive
Last updated in NPPESFeb 21, 2020

Details

NPI
1669907424
Entity type
Individual (NPI-1)
Name
Mrs. Lauren Nichole Vanderburg
Sex
Female
Sole proprietor
No
Enumeration date
Apr 28, 2017
Certification date
Feb 21, 2020
Last updated
Feb 21, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse PractitionerAPN0000022895TNYes

Practice location

3451 Goodman Rd E Ste 115
Southaven, MS 38672-9304

Phone 662-890-5555 · Fax 662-890-8899

Mailing address

3451 Goodman E Rd 115
Southaven, MS 38672-9304

Phone 662-890-5555

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