Provider Demographics
NPI:1518160449
Name:OHEARN, LAURA LEE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEE
Last Name:OHEARN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:TAGGART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:303 WEST BANK SE
Mailing Address - Street 2:APT #2
Mailing Address - City:ALBION
Mailing Address - State:NY
Mailing Address - Zip Code:14411
Mailing Address - Country:US
Mailing Address - Phone:585-283-4202
Mailing Address - Fax:
Practice Address - Street 1:4618 OAK ORCHARD RD
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411
Practice Address - Country:US
Practice Address - Phone:585-589-0576
Practice Address - Fax:585-589-7845
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2660671164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse