Provider Demographics
NPI:1124178173
Name:MCLOUGHLIN, LAURA SUBEL
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:SUBEL
Last Name:MCLOUGHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:SUBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:725 RED LADY AVE.
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-0696
Mailing Address - Country:US
Mailing Address - Phone:970-349-6847
Mailing Address - Fax:
Practice Address - Street 1:225 N PINE ST STE E
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2648
Practice Address - Country:US
Practice Address - Phone:970-641-0209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO163228163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse