Provider Demographics
NPI:1689920357
Name:NAZZARO, LAURA HARVEY (PMHNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:HARVEY
Last Name:NAZZARO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10420 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8502
Mailing Address - Country:US
Mailing Address - Phone:980-237-4766
Mailing Address - Fax:980-404-2274
Practice Address - Street 1:10420 PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8502
Practice Address - Country:US
Practice Address - Phone:980-237-4766
Practice Address - Fax:980-404-2274
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX817885363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health