Provider Demographics
NPI:1235486846
Name:LAUERMAN, JESSICA TYSON (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:TYSON
Last Name:LAUERMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 ACADEMY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2660
Mailing Address - Country:US
Mailing Address - Phone:919-403-8600
Mailing Address - Fax:919-489-8585
Practice Address - Street 1:3001 ACADEMY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2660
Practice Address - Country:US
Practice Address - Phone:919-403-8600
Practice Address - Fax:919-489-8585
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC237995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily