Provider Demographics
NPI:1376141184
Name:AHUMADA, LAURA E (NP)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:E
Last Name:AHUMADA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 N SAND CREEK CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-7126
Mailing Address - Country:US
Mailing Address - Phone:520-235-0036
Mailing Address - Fax:
Practice Address - Street 1:5369 S CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-3963
Practice Address - Country:US
Practice Address - Phone:520-573-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ247919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily