| Doctor Name: | LAURA ELISE HIDAY |
| NPI Number: | 1033496351 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 21348 |
| Business Practice Address: | 255 Terracina Blvd Suite #205 A,b Redlands, CA - 923734870 |
| Business Phone Number: | 9097928866 |
| Business Fax Number: | 9097929395 |
| Mailing Address: | 255 Terracina Blvd, Suite #205 A,b REDLANDS |
| State: | CA |
| Postal Code: | 923734870 |
| Phone Number: | 9097928866 |
| Fax Number: | 9097929395 |
| NPI Enumeration Date: | 11/15/2011 |
| NPI Last Update Date: | 05/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 21348 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |