Provider Demographics
NPI:1033207394
Name:LALANNE, MIREILLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MIREILLE
Middle Name:
Last Name:LALANNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 21ST AVE NORTH
Mailing Address - Street 2:#206
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6404
Mailing Address - Country:US
Mailing Address - Phone:615-329-9933
Mailing Address - Fax:615-329-9906
Practice Address - Street 1:121 21ST AVE NORTH
Practice Address - Street 2:#206
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6404
Practice Address - Country:US
Practice Address - Phone:615-329-9933
Practice Address - Fax:615-329-9906
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD14207207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B04724Medicare UPIN
TN3196775Medicare ID - Type Unspecified