Provider Demographics
NPI:1851905186
Name:GODIN, LAURA MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:GODIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 ROBBINS AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-5269
Mailing Address - Country:US
Mailing Address - Phone:978-895-2989
Mailing Address - Fax:
Practice Address - Street 1:246 MILL ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3310
Practice Address - Country:US
Practice Address - Phone:978-534-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2274347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily