Provider Demographics
NPI:1194238071
Name:TEMPLETON, LAURA JESSICA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JESSICA
Last Name:TEMPLETON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 W FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-5611
Mailing Address - Country:US
Mailing Address - Phone:423-439-7371
Mailing Address - Fax:423-212-0420
Practice Address - Street 1:202 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5611
Practice Address - Country:US
Practice Address - Phone:423-439-7371
Practice Address - Fax:423-232-0420
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175577363LF0000X
TN33914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily