Provider Demographics
NPI:1790290575
Name:LAURIA, ALEXANDRA (RN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:LAURIA
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 1:48 BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-4605
Mailing Address - Country:US
Mailing Address - Phone:781-367-3188
Mailing Address - Fax:
Practice Address - Street 1:48 BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-4605
Practice Address - Country:US
Practice Address - Phone:781-290-7305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-03
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2320581163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health