Provider Demographics
NPI:1609045269
Name:KEATON, LAURA MCDOWELL (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MCDOWELL
Last Name:KEATON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MCDOWELL
Other - Last Name:KEATON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, RSN, FNP-C
Mailing Address - Street 1:404 SOUTH SUTHERLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5060
Mailing Address - Country:US
Mailing Address - Phone:704-291-9267
Mailing Address - Fax:704-283-7939
Practice Address - Street 1:812 WEST INNES STREET
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4152
Practice Address - Country:US
Practice Address - Phone:704-637-5544
Practice Address - Fax:704-637-1989
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-03870363LF0000X
NC133760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily