Provider Demographics
NPI:1689115545
Name:LARRUMBIDE, LAURA KRISTIN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:KRISTIN
Last Name:LARRUMBIDE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1006
Mailing Address - Country:US
Mailing Address - Phone:504-678-3660
Mailing Address - Fax:
Practice Address - Street 1:400 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1006
Practice Address - Country:US
Practice Address - Phone:504-678-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-12
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant