Provider Demographics
NPI:1033366372
Name:FAIRFIELD, LAURA CHRISTINE
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:CHRISTINE
Last Name:FAIRFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 MIRASSON AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-0892
Mailing Address - Country:US
Mailing Address - Phone:559-685-1001
Mailing Address - Fax:
Practice Address - Street 1:22212 ROAD 236
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-9721
Practice Address - Country:US
Practice Address - Phone:559-562-6549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN161634164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse