Provider Demographics
NPI:1346479722
Name:DAVIS, LAURA THOMASSEN (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:THOMASSEN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:THOMASSEN
Other - Last Name:JELSMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:300 S. JACKSON ST.
Mailing Address - Street 2:STE 320
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:303-316-6677
Mailing Address - Fax:303-316-5004
Practice Address - Street 1:300 S. JACKSON ST. STE 320
Practice Address - Street 2:ARACEA WOMEN'S CARE
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209
Practice Address - Country:US
Practice Address - Phone:303-316-6677
Practice Address - Fax:303-316-5004
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5977363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health