Provider Demographics
NPI:1932686805
Name:HOWARD, LAUREL ROY (RN)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:ROY
Last Name:HOWARD
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 1:120 FOX RUN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-5410
Mailing Address - Country:US
Mailing Address - Phone:828-785-6522
Mailing Address - Fax:
Practice Address - Street 1:975 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3001
Practice Address - Country:US
Practice Address - Phone:585-256-3430
Practice Address - Fax:585-286-9226
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY574810163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health