Provider Demographics
NPI:1578984332
Name:PEARSON, LAURA E (MS, CNM)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MS, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9260 W SUNSET RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4858
Mailing Address - Country:US
Mailing Address - Phone:702-255-3547
Mailing Address - Fax:702-921-2419
Practice Address - Street 1:715 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4209
Practice Address - Country:US
Practice Address - Phone:970-249-6737
Practice Address - Fax:970-252-0112
Is Sole Proprietor?:No
Enumeration Date:2013-12-21
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001999367A00000X
COAPN.0991031-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV111989Medicare PIN