Provider Demographics
NPI:1073748919
Name:VANPATTEN, LAURA ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELIZABETH
Last Name:VANPATTEN
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:6600 PEACHTREE DUNWOODY RD STE 325
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6773
Mailing Address - Country:US
Mailing Address - Phone:404-876-1906
Mailing Address - Fax:404-215-9222
Practice Address - Street 1:6135 BARFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-256-8500
Practice Address - Fax:404-256-8506
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2020-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA149681363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20250I5252Medicare PIN