Provider Demographics
NPI:1831354745
Name:KANU, LAURA (RN)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:KANU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 S KIRKWOOD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEADOWS PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3044
Mailing Address - Country:US
Mailing Address - Phone:281-980-1006
Mailing Address - Fax:281-980-1007
Practice Address - Street 1:12221 S KIRKWOOD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MEADOWS PLACE
Practice Address - State:TX
Practice Address - Zip Code:77477-3044
Practice Address - Country:US
Practice Address - Phone:281-980-1006
Practice Address - Fax:281-980-1007
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595403171M00000X
TXAP117925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171M00000XOther Service ProvidersCase Manager/Care Coordinator