Provider Demographics
NPI:1326462698
Name:FLORMAN, LAURA (PMHNP, RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FLORMAN
Suffix:
Gender:F
Credentials:PMHNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TACOMA ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3516
Mailing Address - Country:US
Mailing Address - Phone:508-852-1805
Mailing Address - Fax:508-853-8593
Practice Address - Street 1:2000 CENTURY DR
Practice Address - Street 2:CREDENTIALING-ADMINITRATION
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-1256
Practice Address - Country:US
Practice Address - Phone:508-854-2122
Practice Address - Fax:508-853-8593
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2272332363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health