Provider Demographics
NPI:1396852810
Name:CHANEY, LURLINE (CRNP)
Entity Type:Individual
Prefix:
First Name:LURLINE
Middle Name:
Last Name:CHANEY
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 1:156 E 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-3516
Mailing Address - Country:US
Mailing Address - Phone:251-948-4290
Mailing Address - Fax:
Practice Address - Street 1:25910 CANAL RD SUITE D
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561
Practice Address - Country:US
Practice Address - Phone:251-974-2273
Practice Address - Fax:239-552-7690
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9364363363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009869300Medicaid
FLY0KK0OtherBCBS
FLHP524VOtherMEDICARE
FLY0KK0OtherBCBS