Provider Demographics
NPI:1144795071
Name:LU, LAURENE (NP)
Entity Type:Individual
Prefix:
First Name:LAURENE
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAURENE
Other - Middle Name:ZARAGOZA
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 WILLOW GLEN CIR APT 84
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-8300
Mailing Address - Country:US
Mailing Address - Phone:860-501-4373
Mailing Address - Fax:
Practice Address - Street 1:80 LAMBERT LIND HWY STE 10
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1180
Practice Address - Country:US
Practice Address - Phone:401-739-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN46915163W00000X
RIAPRN01806363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse