Provider Demographics
NPI:1831375732
Name:PEOPLES, LAURIE ELLEN
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:ELLEN
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:ELLEN
Other - Last Name:JANCSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1947 CENTER ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1169
Mailing Address - Country:US
Mailing Address - Phone:510-981-7684
Mailing Address - Fax:510-981-5345
Practice Address - Street 1:1947 CENTER ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1169
Practice Address - Country:US
Practice Address - Phone:510-981-7684
Practice Address - Fax:510-981-5345
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN320557163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse