Provider Demographics
NPI:1245634823
Name:OATES, LAURA JUNE (PNP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JUNE
Last Name:OATES
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SUNNYBROOK RD
Mailing Address - Street 2:SUITE116
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1855
Mailing Address - Country:US
Mailing Address - Phone:919-250-3478
Mailing Address - Fax:
Practice Address - Street 1:23 SUNNYBROOK RD
Practice Address - Street 2:SUITE116
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1855
Practice Address - Country:US
Practice Address - Phone:919-250-3478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007227363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics