Provider Demographics
NPI:1205910510
Name:DYKES, LAURA E (FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:DYKES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6444 N KENNEDY AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-4329
Mailing Address - Country:US
Mailing Address - Phone:559-691-1958
Mailing Address - Fax:
Practice Address - Street 1:973 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:93246-9324
Practice Address - Country:US
Practice Address - Phone:559-998-2016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP5737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily