Provider Demographics
NPI:1992015788
Name:JONES, LAURIE J (NP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 GATEWAY BLVD N
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-9658
Mailing Address - Country:US
Mailing Address - Phone:219-921-1444
Mailing Address - Fax:219-921-0533
Practice Address - Street 1:600 LEGACY PLAZA EAST
Practice Address - Street 2:
Practice Address - City:LAPORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-5268
Practice Address - Country:US
Practice Address - Phone:219-921-1444
Practice Address - Fax:219-921-5303
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71003380A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71003380AOtherLICENSE