Provider Demographics
NPI:1912026535
Name:MACPHERSON, LAURIE M (CNM)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:M
Last Name:MACPHERSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:M
Other - Last Name:MACPHERSON-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:844 KEMPSVILLE ROAD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502
Mailing Address - Country:US
Mailing Address - Phone:757-461-3890
Mailing Address - Fax:757-461-0836
Practice Address - Street 1:828 HEALTHY WAY
Practice Address - Street 2:SUITE 330
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-461-3890
Practice Address - Fax:757-467-0301
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001084733367A00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024084733OtherVIRGINIA LICENSE