Provider Demographics
NPI:1659589471
Name:MCLAURIN, LYDIA DOLORES (RN)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:DOLORES
Last Name:MCLAURIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 N MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-2439
Mailing Address - Country:US
Mailing Address - Phone:352-726-1731
Mailing Address - Fax:352-637-5397
Practice Address - Street 1:120 N MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450-2439
Practice Address - Country:US
Practice Address - Phone:352-726-1731
Practice Address - Fax:352-637-5397
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2032472163WS0200X
FL251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WS0200XNursing Service ProvidersRegistered NurseSchool
Not Answered251K00000XAgenciesPublic Health or Welfare