Provider Demographics
NPI:1396451613
Name:DEMERI, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DEMERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4906
Mailing Address - Country:US
Mailing Address - Phone:503-998-8354
Mailing Address - Fax:
Practice Address - Street 1:3704 MURPHY RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4906
Practice Address - Country:US
Practice Address - Phone:503-998-8354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3189559171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach