Provider Demographics
NPI:1245796044
Name:LANEY, LAURA (CNM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LANEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7443 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1661
Mailing Address - Country:US
Mailing Address - Phone:816-838-2095
Mailing Address - Fax:
Practice Address - Street 1:4625 LINDELL BOULEVARD
Practice Address - Street 2:
Practice Address - City:ST.LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3739
Practice Address - Country:US
Practice Address - Phone:914-919-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020029263367A00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO250089451Medicaid