Provider Demographics
NPI:1649671876
Name:FRANCOEUR, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FRANCOEUR
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 1:36 ELM ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4902
Mailing Address - Country:US
Mailing Address - Phone:617-471-1161
Mailing Address - Fax:617-376-0435
Practice Address - Street 1:300 CONGRESS ST
Practice Address - Street 2:SUITE 102
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0907
Practice Address - Country:US
Practice Address - Phone:617-479-6636
Practice Address - Fax:617-376-0435
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN265632364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health