Basic Information
| Provider Information | |||||||||
| NPI: | 1891706701 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAHAR | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PMH-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | CO | ||||||||
| PostalCode: | 807513168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9705224549 | ||||||||
| FaxNumber: | 9705226898 | ||||||||
| Practice Location | |||||||||
| Address1: | 821 E RAILROAD AVE | ||||||||
| Address2: | |||||||||
| City: | FORT MORGAN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 807013365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708674924 | ||||||||
| FaxNumber: | 9708672695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 12/19/2017 | ||||||||
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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 | 163WP0808X | APN.0990620-NP | CO | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LP0808X | 0990620 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.