Provider Demographics
NPI:1316809809
Name:LAURY, JODDIE MARIE (CNA)
Entity type:Individual
Prefix:
First Name:JODDIE
Middle Name:MARIE
Last Name:LAURY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 RESOLUTION PT APT 212
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7364
Mailing Address - Country:US
Mailing Address - Phone:850-712-4685
Mailing Address - Fax:
Practice Address - Street 1:945 RESOLUTION PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7347
Practice Address - Country:US
Practice Address - Phone:850-712-4685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00837743376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide