Provider Demographics
NPI:1639279565
Name:MACLEOD, LAURIE K (CNM)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:K
Last Name:MACLEOD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:K
Other - Last Name:KARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-690-7596
Mailing Address - Fax:419-697-6707
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-789-3029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM545367A00000X
OH14142NM367A00000X
CT494367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife