Provider Demographics
NPI:1386988780
Name:STOGNER, LAURA (DNP STUDENT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STOGNER
Suffix:
Gender:F
Credentials:DNP STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 JONES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4712
Mailing Address - Country:US
Mailing Address - Phone:301-649-1840
Mailing Address - Fax:
Practice Address - Street 1:4301 JONES BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-295-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA085468163WP0808X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health