Provider Demographics
NPI:1265683411
Name:ELIA, LAURA (CRNFA,RN,BSN, MSN NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ELIA
Suffix:
Gender:F
Credentials:CRNFA,RN,BSN, MSN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23-06 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2906
Mailing Address - Country:US
Mailing Address - Phone:201-794-7865
Mailing Address - Fax:
Practice Address - Street 1:23-06 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2906
Practice Address - Country:US
Practice Address - Phone:201-230-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26N010003100163WR0006X
NJAG10190094363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant