| Doctor Name: | LAURA C WASIELEWSKI |
| NPI Number: | 1083037279 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 18139 |
| Business Practice Address: | 100b Mallard Sunrise Dr E Westmoreland, TN - 371863251 |
| Business Phone Number: | 6156443000 |
| Business Fax Number: | 6156443076 |
| Mailing Address: | Po Box 9150, PADUCAH |
| State: | KY |
| Postal Code: | 420029150 |
| Phone Number: | 2707449600 |
| Fax Number: | 2707440834 |
| NPI Enumeration Date: | 01/24/2014 |
| NPI Last Update Date: | 01/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 18139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |