Provider Demographics
NPI:1154965853
Name:MCNAMARA, LAURA J (MSN RN CCNS CCRN-K)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:J
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:MSN RN CCNS CCRN-K
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 CITY LIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2671
Mailing Address - Country:US
Mailing Address - Phone:405-706-7317
Mailing Address - Fax:
Practice Address - Street 1:7210 CITY LIGHTS DR
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2671
Practice Address - Country:US
Practice Address - Phone:405-706-7317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA687162163WC0200X
TX604631163WC0200X
CA3446364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine