Provider Demographics
NPI:1760445985
Name:FRENCH, LAURA M (PNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:FRENCH
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 S VAL VISTA DR
Mailing Address - Street 2:SUITE 161
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1675
Mailing Address - Country:US
Mailing Address - Phone:480-857-6316
Mailing Address - Fax:480-857-6638
Practice Address - Street 1:2730 S VAL VISTA DR
Practice Address - Street 2:SUITE 161
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1675
Practice Address - Country:US
Practice Address - Phone:480-857-6316
Practice Address - Fax:480-857-6638
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN065042363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ557530Medicaid
S54951Medicare UPIN
107300Medicare ID - Type Unspecified