Provider Demographics
NPI:1508945999
Name:ANDERSON, LAURA L (WHNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1657
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76241-1657
Mailing Address - Country:US
Mailing Address - Phone:940-665-0605
Mailing Address - Fax:940-665-0770
Practice Address - Street 1:1213 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2810
Practice Address - Country:US
Practice Address - Phone:940-665-0605
Practice Address - Fax:940-665-0770
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX512659363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner