Provider Demographics
NPI:1205375524
Name:HARKINS, LAUREEN ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:LAUREEN
Middle Name:ANN
Last Name:HARKINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 METROPOLITAN CT
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4016
Mailing Address - Country:US
Mailing Address - Phone:240-773-0300
Mailing Address - Fax:240-773-0301
Practice Address - Street 1:7 METROPOLITAN CT
Practice Address - Street 2:SUITE 1
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-4016
Practice Address - Country:US
Practice Address - Phone:240-773-0300
Practice Address - Fax:240-773-0301
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR089539363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care