Provider Demographics
NPI:1326276056
Name:ARCHER, LAURA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:ARCHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:STARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9371 S COUNTY ROAD 100 E
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:IN
Mailing Address - Zip Code:46118-9215
Mailing Address - Country:US
Mailing Address - Phone:317-539-7894
Mailing Address - Fax:
Practice Address - Street 1:1402 E COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0963
Practice Address - Country:US
Practice Address - Phone:317-887-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28108666A163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator