Provider Demographics
NPI:1093874729
Name:WEDDLE, LAURA L (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:L
Last Name:WEDDLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BEHAVIORAL MEDICINE NETWORK
Mailing Address - Street 2:861 CORPORATE DRIVE SUITE 103
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-224-2022
Mailing Address - Fax:859-224-2024
Practice Address - Street 1:BEHAVIORAL MEDICINE NETWORK
Practice Address - Street 2:861 CORPORATE DRIVE SUITE 103
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-224-2022
Practice Address - Fax:859-224-2024
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2801S363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health