Provider Demographics
NPI:1780126581
Name:MAURER, LAURA (MSN, RNC, FNP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MAURER
Suffix:
Gender:F
Credentials:MSN, RNC, FNP-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2609 E CANNON DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3720
Mailing Address - Country:US
Mailing Address - Phone:480-567-4321
Mailing Address - Fax:
Practice Address - Street 1:2609 E CANNON DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3720
Practice Address - Country:US
Practice Address - Phone:480-567-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9567363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily