Provider Demographics
NPI:1194203851
Name:FESSLER, LAURA MARIE (MSN, CCRN, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:FESSLER
Suffix:
Gender:F
Credentials:MSN, CCRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 MARSH LN APT 214
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4852
Mailing Address - Country:US
Mailing Address - Phone:847-302-5007
Mailing Address - Fax:
Practice Address - Street 1:2300 MARSH LN APT 214
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-4852
Practice Address - Country:US
Practice Address - Phone:847-302-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137543363LG0600X, 363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health