Provider Demographics
NPI:1235870734
Name:EICHER, LAUREL LEA (RN, MSN, ACGNP)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:LEA
Last Name:EICHER
Suffix:
Gender:F
Credentials:RN, MSN, ACGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 E CROSS ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-3501
Mailing Address - Country:US
Mailing Address - Phone:319-666-4224
Mailing Address - Fax:877-384-3106
Practice Address - Street 1:1208 E CROSS ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-3501
Practice Address - Country:US
Practice Address - Phone:319-666-4224
Practice Address - Fax:877-384-3106
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH165196363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care