Provider Demographics
NPI:1700446366
Name:CORMIER, LAURENMARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURENMARIE
Middle Name:
Last Name:CORMIER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BIRCH ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-1596
Mailing Address - Country:US
Mailing Address - Phone:508-397-6597
Mailing Address - Fax:
Practice Address - Street 1:42 BIRCH ISLAND RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-1596
Practice Address - Country:US
Practice Address - Phone:508-397-6597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA153109163W00000X
MARN2261744163W00000X, 163W00000X
IN28245046A163W00000X
HI91906163W00000X
FLRN9484700163W00000X
DCRN1050717163W00000X
CT158156163W00000X
CA95167136163W00000X
AZ225123163W00000X
ID61054163W00000X
AL1-172022163W00000X
CO1656478163W00000X
GARN281872163W00000X
IL209024587363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily