Provider Demographics
NPI:1154498616
Name:BROWN, LAURA MCGEACHY (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MCGEACHY
Last Name:BROWN
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 1:5213 S. ALSTON AVENUE
Mailing Address - Street 2:PRIVATE DIAGNOSTIC CLINIC, PLLC
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-620-5041
Mailing Address - Fax:
Practice Address - Street 1:2406 BLUE RIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6680
Practice Address - Country:US
Practice Address - Phone:919-783-4299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200385363LP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2592444BMedicare ID - Type Unspecified
R41897Medicare ID - Type Unspecified