Provider Demographics
NPI:1285790949
Name:FIELDS, LAUREL S (MS)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:S
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18TH MEDCOM
Mailing Address - Street 2:ATTN DCCS QM CREDENTIALS
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205 0054
Mailing Address - Country:KR
Mailing Address - Phone:0118227-916-6087
Mailing Address - Fax:0118227-917-8110
Practice Address - Street 1:18TH MEDCOM
Practice Address - Street 2:ATTN DCCS QM CREDENTIALS
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-0054
Practice Address - Country:KR
Practice Address - Phone:0118227-917-6105
Practice Address - Fax:0118227-917-8110
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT32741835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology