Provider Demographics
NPI:1609050319
Name:KOHLMANN, LAURA A (RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:KOHLMANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WINTERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3033
Mailing Address - Country:US
Mailing Address - Phone:845-561-7005
Mailing Address - Fax:845-938-6541
Practice Address - Street 1:900 WASHINGTON RD
Practice Address - Street 2:FAMILY PRACTICE CLINIC ROOM 1F19
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1109
Practice Address - Country:US
Practice Address - Phone:845-938-3244
Practice Address - Fax:845-938-6541
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312393-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000OtherUPIN