Provider Demographics
NPI:1013369768
Name:SQUIRES, LEE ANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:LEE ANNE
Middle Name:
Last Name:SQUIRES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LEE ANNE
Other - Middle Name:
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-2958
Mailing Address - Country:US
Mailing Address - Phone:251-287-8886
Mailing Address - Fax:251-380-7308
Practice Address - Street 1:1515 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2958
Practice Address - Country:US
Practice Address - Phone:251-287-8886
Practice Address - Fax:251-380-7308
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-105211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily