Provider Demographics
NPI:1861670556
Name:AUSTIN, LAURA MASSIE (RN,PHN,MSN,P-C CNS)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MASSIE
Last Name:AUSTIN
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Gender:F
Credentials:RN,PHN,MSN,P-C CNS
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Other - First Name:
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Mailing Address - Street 1:123 W MANCHESTER BLVD
Mailing Address - Street 2:SUITE 231
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1753
Mailing Address - Country:US
Mailing Address - Phone:310-419-5307
Mailing Address - Fax:310-330-7010
Practice Address - Street 1:123 W MANCHESTER BLVD
Practice Address - Street 2:SUITE 231
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1753
Practice Address - Country:US
Practice Address - Phone:310-419-5307
Practice Address - Fax:310-330-7010
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA463789163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management