Provider Demographics
NPI:1932410958
Name:MCCAIN, LAURA L (NP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W WALNUT ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-1377
Mailing Address - Country:US
Mailing Address - Phone:270-699-9500
Mailing Address - Fax:270-699-9550
Practice Address - Street 1:325 W WALNUT ST
Practice Address - Street 2:SUITE 600
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1377
Practice Address - Country:US
Practice Address - Phone:270-699-9500
Practice Address - Fax:270-699-9550
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6485P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner