Provider Demographics
NPI:1477108603
Name:HAURY, LAURIE IRENE (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:IRENE
Last Name:HAURY
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 E TALL TREE RD
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2000
Mailing Address - Country:US
Mailing Address - Phone:316-274-8222
Mailing Address - Fax:316-651-2344
Practice Address - Street 1:1640 E TALL TREE RD
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2000
Practice Address - Country:US
Practice Address - Phone:316-274-8222
Practice Address - Fax:316-651-2344
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78745363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner