Provider Demographics
NPI:1255453007
Name:ARENA, LAURIE L (MSW, NP, RN)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:L
Last Name:ARENA
Suffix:
Gender:F
Credentials:MSW, NP, RN
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:L
Other - Last Name:GREGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, NP, RN
Mailing Address - Street 1:612 N GREENE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2024
Mailing Address - Country:US
Mailing Address - Phone:336-604-5100
Mailing Address - Fax:336-604-5151
Practice Address - Street 1:2670 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2829
Practice Address - Country:US
Practice Address - Phone:844-866-1166
Practice Address - Fax:919-251-9008
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214151104100000X
MARN2262641163W00000X, 363LP0808X
NC5005752363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002091701Medicare PIN