Doctor Name: | MS. LAURALEE MARIE SPRAGUE |
NPI Number: | 1508820374 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | F333702 |
Business Practice Address: | 100 Memorial Dr Gowanda, NY - 140701111 |
Business Phone Number: | 7165328799 |
Business Fax Number: | 7165328787 |
Mailing Address: | 11159 Route 39, GOWANDA |
State: | NY |
Postal Code: | 140709618 |
Phone Number: | 7165321580 |
Fax Number: | 7165328787 |
NPI Enumeration Date: | 04/17/2006 |
NPI Last Update Date: | 10/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F333702 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |