Provider Demographics
NPI:1164768446
Name:ROY, LAURA LYNN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNN
Last Name:ROY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 6TH INFANTRY RD
Mailing Address - Street 2:
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-1145
Mailing Address - Country:US
Mailing Address - Phone:619-227-0184
Mailing Address - Fax:
Practice Address - Street 1:20375 W 151ST ST STE 270
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5360
Practice Address - Country:US
Practice Address - Phone:913-780-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-14
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX704041363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health