Doctor Name: | MS. LAURA CARLISLE HUENINK |
NPI Number: | 1285808279 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | RN168244 |
Business Practice Address: | 176 Marietta Hwy Hiram Hiram, GA - 301411836 |
Business Phone Number: | 6789458200 |
Business Fax Number: | 6789458209 |
Mailing Address: | 176 Marietta Hwy, Hiram HIRAM |
State: | GA |
Postal Code: | 301411836 |
Phone Number: | 6789458200 |
Fax Number: | 6789458209 |
NPI Enumeration Date: | 04/22/2008 |
NPI Last Update Date: | 07/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | RN168244 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |