Provider Demographics
NPI:1730460064
Name:KOEHLER, LAUREEN C (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREEN
Middle Name:C
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 HUBS REC RD
Mailing Address - Street 2:
Mailing Address - City:BELHAVEN
Mailing Address - State:NC
Mailing Address - Zip Code:27810-9336
Mailing Address - Country:US
Mailing Address - Phone:252-944-3690
Mailing Address - Fax:252-359-5328
Practice Address - Street 1:812 HUBS REC RD
Practice Address - Street 2:
Practice Address - City:BELHAVEN
Practice Address - State:NC
Practice Address - Zip Code:27810-9336
Practice Address - Country:US
Practice Address - Phone:252-944-3690
Practice Address - Fax:252-359-5328
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005288363LF0000X, 363L00000X, 363LF0000X
NC189102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC172YMOtherBCBS OF NC
NC1730460064Medicaid
NC1063184182OtherORGANIZATION NPI HOUSE CALLS, LLC
NC1730460064OtherPERSONAL NPI NUMBER
NCNC5807EOtherMEDICARE