Doctor Name: | MRS. LAURA PAUL |
NPI Number: | 1073979548 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | COA.18562-NP |
Business Practice Address: | 90 Jackson Pike Gallipolis, OH - 456311560 |
Business Phone Number: | 7404411949 |
Business Fax Number: | 7404465982 |
Mailing Address: | 280 Pattonsville Road, JACKSON |
State: | OH |
Postal Code: | 45640 |
Phone Number: | 7403958801 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2016 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA.18562-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |