Provider Demographics
NPI:1376880997
Name:MAGOFFIE, LAURA MAE (RN, FNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MAE
Last Name:MAGOFFIE
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40338 N EXPLORATION TRL
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1642
Mailing Address - Country:US
Mailing Address - Phone:623-551-4507
Mailing Address - Fax:623-748-8810
Practice Address - Street 1:2525 W CAREFREE HWY STE 118
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-9302
Practice Address - Country:US
Practice Address - Phone:623-748-9106
Practice Address - Fax:602-429-8579
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily