Provider Demographics
NPI:1275903916
Name:BEHM, LAURA (DNP, FNP-C, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BEHM
Suffix:
Gender:F
Credentials:DNP, FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAINT MARYS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4037
Mailing Address - Country:US
Mailing Address - Phone:240-257-5436
Mailing Address - Fax:301-235-1700
Practice Address - Street 1:1 SAINT MARYS AVE STE 101
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4037
Practice Address - Country:US
Practice Address - Phone:240-257-5436
Practice Address - Fax:301-235-1700
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191044163WL0100X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD254017700Medicaid