Provider Demographics
NPI:1659097533
Name:JUNKER, LAURA DAVILA (APRN AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:DAVILA
Last Name:JUNKER
Suffix:
Gender:F
Credentials:APRN AGACNP-BC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ESTHER
Other - Last Name:DAVILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11811 NW 36TH PL
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3603
Mailing Address - Country:US
Mailing Address - Phone:754-234-5415
Mailing Address - Fax:
Practice Address - Street 1:3100 WESTON RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3602
Practice Address - Country:US
Practice Address - Phone:954-487-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022386363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care