Provider Demographics
NPI:1710298849
Name:MUELLER, LAURIE A (RN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:MUELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 CAZENOVIA ST # 8
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2201
Mailing Address - Country:US
Mailing Address - Phone:716-857-0250
Mailing Address - Fax:
Practice Address - Street 1:3409 GENESEE ST
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-5051
Practice Address - Country:US
Practice Address - Phone:716-855-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY554333-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse