Provider Demographics
NPI:1467401646
Name:HERRING, LAURA JEAN (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:HERRING
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC, CSCS
Mailing Address - Street 1:2436 SANDY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2436 SANDY BROOK LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4055
Practice Address - Country:US
Practice Address - Phone:619-482-6136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179982363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner