Doctor Name: | LAURA K KONDRAT |
NPI Number: | 1205114758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | RN2267778 |
Business Practice Address: | 150 Ansel Hallet Rd West Yarmouth, MA - 026732582 |
Business Phone Number: | 5087718350 |
Business Fax Number: | |
Mailing Address: | 150 Ansel Hallet Rd, WEST YARMOUTH |
State: | MA |
Postal Code: | 026732582 |
Phone Number: | 5087718350 |
Fax Number: | |
NPI Enumeration Date: | 08/02/2011 |
NPI Last Update Date: | 05/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN2267778 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |