Doctor Name: | NICOLE M LAIRD |
NPI Number: | 1568555621 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 1-074541 |
Business Practice Address: | 101 Church St Georgiana, AL - 360334268 |
Business Phone Number: | 3343760380 |
Business Fax Number: | 3343760382 |
Mailing Address: | 300 N College St, GREENVILLE |
State: | AL |
Postal Code: | 360372025 |
Phone Number: | 3343822681 |
Fax Number: | 3343839884 |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 06/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-074541 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |