Provider Demographics
NPI:1235604356
Name:SMITH, LAURA CHRISTINE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:CHRISTINE
Last Name:SMITH
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 1:11416 CR FF
Mailing Address - Street 2:
Mailing Address - City:BLANCA
Mailing Address - State:CO
Mailing Address - Zip Code:81123
Mailing Address - Country:US
Mailing Address - Phone:719-580-8630
Mailing Address - Fax:
Practice Address - Street 1:1131 MAIN ST
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2446
Practice Address - Country:US
Practice Address - Phone:719-580-8630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994196-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily