Provider Demographics
NPI:1740890748
Name:KYRISS, LAURA (CNM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:KYRISS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 W CENTER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2388
Mailing Address - Country:US
Mailing Address - Phone:402-397-6600
Mailing Address - Fax:402-397-8318
Practice Address - Street 1:7205 W CENTER RD STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2388
Practice Address - Country:US
Practice Address - Phone:402-397-6600
Practice Address - Fax:402-397-8318
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB160105367A00000X
NE120087367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife