Provider Demographics
NPI:1982807319
Name:PRESNELL, LAURA BRANTMAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BRANTMAN
Last Name:PRESNELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 DAMUTH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2411
Mailing Address - Country:US
Mailing Address - Phone:510-479-7302
Mailing Address - Fax:
Practice Address - Street 1:2201 DAMUTH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2411
Practice Address - Country:US
Practice Address - Phone:510-479-7302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549778163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant