Provider Demographics
NPI:1710251046
Name:SMITH, LAURA A (APRN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:LONEHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:818 5TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1303
Mailing Address - Country:US
Mailing Address - Phone:877-811-7526
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:5631 S 48TH ST STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:877-811-7526
Practice Address - Fax:515-280-7525
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF1088527363LW0102X
NE111335363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE111335OtherNE STATE LICENSE