Provider Demographics
NPI:1578260295
Name:EARLY, LAURA (RN, CNM)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:EARLY
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2826 BARNSTORMER ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4950
Mailing Address - Country:US
Mailing Address - Phone:608-512-9418
Mailing Address - Fax:
Practice Address - Street 1:1817 JESSUP DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2550
Practice Address - Country:US
Practice Address - Phone:866-218-5769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCNM08042176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife