Provider Demographics
NPI:1649651571
Name:HARMON, LAURIE (RN, APRN-BC)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:HARMON
Suffix:
Gender:F
Credentials:RN, APRN-BC
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:QUIBODEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2223
Mailing Address - Country:US
Mailing Address - Phone:337-468-9011
Mailing Address - Fax:337-468-2702
Practice Address - Street 1:119 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-3034
Practice Address - Country:US
Practice Address - Phone:318-335-0285
Practice Address - Fax:337-468-2702
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08317363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LARN114055OtherR.N. LICENSE NUMBER
LAAP08317OtherAPRN-BC