Doctor Name: | MS. HEATHER RENEE LAQUERRE |
NPI Number: | 1508199274 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, APRN, CNP |
License Number: | 73556 |
Business Practice Address: | 102 N. Broadway Carnegie, OK - 73015 |
Business Phone Number: | 5806541050 |
Business Fax Number: | |
Mailing Address: | 102 N. Broadway, CARNEGIE |
State: | OK |
Postal Code: | 73015 |
Phone Number: | 5806541050 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2009 |
NPI Last Update Date: | 04/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 73556 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |