Provider Demographics
NPI:1720290604
Name:KRUM, LAURIE JEANNE (CRNFA, APN-C)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:JEANNE
Last Name:KRUM
Suffix:
Gender:F
Credentials:CRNFA, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 HAASE AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4508
Mailing Address - Country:US
Mailing Address - Phone:201-265-2314
Mailing Address - Fax:201-265-1431
Practice Address - Street 1:204 HAASE AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4508
Practice Address - Country:US
Practice Address - Phone:201-265-2314
Practice Address - Fax:201-265-1431
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ081637163WR0006X
NJ26NJ00137000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health