Provider Demographics
NPI:1578281556
Name:WARREN-CASHMAN, LAURA JEAN (APRN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:WARREN-CASHMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11610 E HUTCHISON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-7851
Mailing Address - Country:US
Mailing Address - Phone:618-214-5723
Mailing Address - Fax:
Practice Address - Street 1:4500 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5012
Practice Address - Country:US
Practice Address - Phone:618-474-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-025102363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health