Provider Demographics
NPI:1265040612
Name:LAUX, SUZANNE ELISE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ELISE
Last Name:LAUX
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 THIRD AVE
Mailing Address - Street 2:HQ 7TH BDE USACC
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-5117
Mailing Address - Country:US
Mailing Address - Phone:502-626-0648
Mailing Address - Fax:
Practice Address - Street 1:328 3RD AVE
Practice Address - Street 2:
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-5117
Practice Address - Country:US
Practice Address - Phone:502-624-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily