Provider Demographics
NPI:1558612432
Name:ANDERSON, LAUREL ELIZABETH (RN CWCN)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:ELIZABETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN CWCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FOREST AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2882
Mailing Address - Country:US
Mailing Address - Phone:740-588-7888
Mailing Address - Fax:740-588-7856
Practice Address - Street 1:800 FOREST AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2882
Practice Address - Country:US
Practice Address - Phone:740-588-7888
Practice Address - Fax:740-588-7856
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.316860163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care