Provider Demographics
NPI:1821896333
Name:CROSS, LAURA KAY (RN, CDCES)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:CROSS
Suffix:
Gender:
Credentials:RN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 TOMASELLO AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-9445
Mailing Address - Country:US
Mailing Address - Phone:239-229-0629
Mailing Address - Fax:239-343-0735
Practice Address - Street 1:8960 COLONIAL CENTER DR STE 202
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7810
Practice Address - Country:US
Practice Address - Phone:239-343-9646
Practice Address - Fax:239-343-9681
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9190746163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator