Provider Demographics
NPI:1780429894
Name:MYERS, LAURA MICHELLE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHELLE
Last Name:MYERS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 SPRING RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:CHINA SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:76633-2973
Mailing Address - Country:US
Mailing Address - Phone:254-723-0421
Mailing Address - Fax:
Practice Address - Street 1:318 RICHLAND WEST CIR STE A
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7912
Practice Address - Country:US
Practice Address - Phone:254-776-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1148951208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice