Provider Demographics
NPI:1205172749
Name:HOWIE, LAURA ODELL (NP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ODELL
Last Name:HOWIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 CORNWALL CT NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-7736
Mailing Address - Country:US
Mailing Address - Phone:980-621-9344
Mailing Address - Fax:
Practice Address - Street 1:6150 BAYFIELD PKWY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-7486
Practice Address - Country:US
Practice Address - Phone:704-262-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-01
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC201411OtherSTATE OF NORTH CAROLINA FNP LICENSE # 201411, APPROVAL # 500610