Provider Demographics
NPI:1982369997
Name:SCARBROUGH, LAURA LEIGH (NP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEIGH
Last Name:SCARBROUGH
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 1:207 STONE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-1625
Mailing Address - Country:US
Mailing Address - Phone:770-715-9793
Mailing Address - Fax:
Practice Address - Street 1:144 BILL CARRUTH PKWY STE 4200
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3819
Practice Address - Country:US
Practice Address - Phone:678-324-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN236330363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health