Provider Demographics
NPI:1932765583
Name:TEMPLE, LAURA JANINE (PMHNP, RN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JANINE
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:PMHNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 MANHATTAN AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-1625
Mailing Address - Country:US
Mailing Address - Phone:516-550-3415
Mailing Address - Fax:
Practice Address - Street 1:960 MANHATTAN AVE FL 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-1625
Practice Address - Country:US
Practice Address - Phone:516-550-3415
Practice Address - Fax:516-531-8782
Is Sole Proprietor?:No
Enumeration Date:2019-05-18
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402701363LP0808X
NY659632163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse