Provider Demographics
NPI:1891496386
Name:MEEHAN, LAURA ANNE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:MEEHAN
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 1:165 THORNDIKE ST FL 4
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-3485
Mailing Address - Country:US
Mailing Address - Phone:978-955-9500
Mailing Address - Fax:978-970-1115
Practice Address - Street 1:165 THORNDIKE ST FL 4
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-3485
Practice Address - Country:US
Practice Address - Phone:978-955-9500
Practice Address - Fax:978-970-1115
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAF122220305363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care