Provider Demographics
NPI:1376880997
Name:MAGOFFIE, LAURA MAE (RN, FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MAE
Last Name:MAGOFFIE
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39506 N DAISY MOUNTAIN DR STE 122169
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-6068
Mailing Address - Country:US
Mailing Address - Phone:623-748-9106
Mailing Address - Fax:602-429-8579
Practice Address - Street 1:2525 W CAREFREE HWY STE 124
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-6095
Practice Address - Country:US
Practice Address - Phone:623-748-9106
Practice Address - Fax:602-429-8579
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily