Provider Demographics
NPI:1922696137
Name:LAPRAIRIE, CALAN EVELYN
Entity Type:Individual
Prefix:
First Name:CALAN
Middle Name:EVELYN
Last Name:LAPRAIRIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4224
Mailing Address - Country:US
Mailing Address - Phone:518-932-9294
Mailing Address - Fax:
Practice Address - Street 1:177 SOUTH ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4224
Practice Address - Country:US
Practice Address - Phone:518-932-9294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY807526-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse