Provider Demographics
NPI:1851055776
Name:MAY, LAURA L (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:MAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9471 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GOODRICH
Mailing Address - State:MI
Mailing Address - Zip Code:48438-9480
Mailing Address - Country:US
Mailing Address - Phone:248-642-9893
Mailing Address - Fax:248-717-1819
Practice Address - Street 1:9471 RIDGE RD
Practice Address - Street 2:
Practice Address - City:GOODRICH
Practice Address - State:MI
Practice Address - Zip Code:48438-9480
Practice Address - Country:US
Practice Address - Phone:248-642-9893
Practice Address - Fax:248-717-1819
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704304956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily