Provider Demographics
NPI:1003159609
Name:WILL, LAURA MONROE (NP, RN)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MONROE
Last Name:WILL
Suffix:
Gender:F
Credentials:NP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BRADSTON ST
Mailing Address - Street 2:ATTN: MEDICAL SERVICES DEPT H.S.A SUFFOLK CORRECTIONS
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2705
Mailing Address - Country:US
Mailing Address - Phone:617-635-1000
Mailing Address - Fax:
Practice Address - Street 1:20 BRADSTON ST
Practice Address - Street 2:ATTN: MEDICAL SERVICES DEPT H.S.A SUFFOLK CORRECTIONS
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2705
Practice Address - Country:US
Practice Address - Phone:617-635-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2290930363L00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse