Provider Demographics
NPI:1215829304
Name:MAYENSCHEIN, LAURIE (RN)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:MAYENSCHEIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 E SANDERS ST
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-9376
Mailing Address - Country:US
Mailing Address - Phone:919-628-3380
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1903
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-1903
Practice Address - Country:US
Practice Address - Phone:919-631-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC152949163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse