Provider Demographics
NPI:1861688897
Name:ESCALANTE, LAURIE B (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:B
Last Name:ESCALANTE
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 1:1460 N PINAL AVE
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-3337
Mailing Address - Country:US
Mailing Address - Phone:520-876-3627
Mailing Address - Fax:
Practice Address - Street 1:1460 N PINAL AVE
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-3337
Practice Address - Country:US
Practice Address - Phone:520-876-3627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN054368163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool