Basic Information
| Provider Information | |||||||||
| NPI: | 1083754584 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STUART | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | RNC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 S SCHEUBER RD | ||||||||
| Address2: | |||||||||
| City: | CENTRALIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985318877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603308950 | ||||||||
| FaxNumber: | 3603309855 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 S SCHEUBER RD | ||||||||
| Address2: | |||||||||
| City: | CENTRALIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985318877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603308950 | ||||||||
| FaxNumber: | 3603309855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WR0006X | RN00080004 | WA | Y | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant |
No ID Information.