Provider Demographics
NPI:1760009971
Name:DUNLEVY, LAURA E (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:DUNLEVY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:DUNLEVY JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:10828 KENDIG RD
Mailing Address - Street 2:
Mailing Address - City:NEW CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45344-8814
Mailing Address - Country:US
Mailing Address - Phone:937-935-3681
Mailing Address - Fax:
Practice Address - Street 1:1161 E DAYTON YELLOW SPRINGS RD
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-6325
Practice Address - Country:US
Practice Address - Phone:937-318-3930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704363812363LF0000X
OH0032925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily