Provider Demographics
NPI:1952630311
Name:LEFEVER, LAURA LYNN (MSN CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:LEFEVER
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11328 N FLAT GRANITE DR
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-4609
Mailing Address - Country:US
Mailing Address - Phone:717-799-1733
Mailing Address - Fax:
Practice Address - Street 1:11328 N FLAT GRANITE DR
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-4609
Practice Address - Country:US
Practice Address - Phone:717-799-1733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ224922363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2518076OtherHIGHMARK BLUE SHIELD-WMG
PA1591259OtherGATEWAY-WMG
MD965752OtherCAREFIRST MD BCBS-WMG
MD965752OtherCAREFIRST MD BCBS-WMG