Provider Demographics
NPI:1598959462
Name:ROUTHIER, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ROUTHIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GRACE LN
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-6130
Mailing Address - Country:US
Mailing Address - Phone:508-943-8670
Mailing Address - Fax:
Practice Address - Street 1:16 GRACE LN
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-6130
Practice Address - Country:US
Practice Address - Phone:508-943-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51480164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse