Provider Demographics
NPI:1629422654
Name:SINK, LAURA M (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:SINK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:LUKENS-SINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:679 E COUNTY LINE ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1049
Mailing Address - Country:US
Mailing Address - Phone:317-807-1266
Mailing Address - Fax:317-859-4269
Practice Address - Street 1:14300 E 138TH STREET, BLDG A
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-0087
Practice Address - Country:US
Practice Address - Phone:317-813-1660
Practice Address - Fax:317-813-1667
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28181347A363LF0000X
IN71007335A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71007335AOtherMEDICAL LICENSE