Provider Demographics
NPI:1154302792
Name:LAMBERT, ANN W (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:W
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 BELLEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-1304
Mailing Address - Country:US
Mailing Address - Phone:251-867-3608
Mailing Address - Fax:251-867-3610
Practice Address - Street 1:1205 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1304
Practice Address - Country:US
Practice Address - Phone:251-867-3608
Practice Address - Fax:251-867-3610
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-0498662080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL891003040Medicaid
AL51511894LAMOtherBCBS OF ALABAMA
AL78307Medicare UPIN