Provider Demographics
NPI:1427564061
Name:GARRISON, LAURALEE (RN)
Entity Type:Individual
Prefix:
First Name:LAURALEE
Middle Name:
Last Name:GARRISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LAURALEE
Other - Middle Name:
Other - Last Name:GOLDSBOROUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:77 RACE ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6632
Mailing Address - Country:US
Mailing Address - Phone:978-397-6446
Mailing Address - Fax:
Practice Address - Street 1:77 RACE ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6632
Practice Address - Country:US
Practice Address - Phone:978-397-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse