Provider Demographics
NPI:1407596497
Name:BOND, LAURA JOANN (RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JOANN
Last Name:BOND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CRESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-3919
Mailing Address - Country:US
Mailing Address - Phone:256-458-5727
Mailing Address - Fax:
Practice Address - Street 1:54 CRESTWOOD LN
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-3919
Practice Address - Country:US
Practice Address - Phone:256-458-5727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-114436163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-114436OtherREGISTER NURSE