Provider Demographics
NPI:1528337607
Name:MADU, LAURA (DNP PMHNP-BC ,FNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MADU
Suffix:
Gender:F
Credentials:DNP PMHNP-BC ,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28610 HIGHWAY 290 STE F09-233
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5462
Mailing Address - Country:US
Mailing Address - Phone:281-508-7434
Mailing Address - Fax:
Practice Address - Street 1:17030 NANES DR STE 209
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2533
Practice Address - Country:US
Practice Address - Phone:281-508-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007271363LF0000X, 363LP0808X
OHAPRN.CNP.15280363LF0000X
TXAP125091363LF0000X, 363LP0808X
WV013652363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100912230Medicaid
OH0221137Medicaid
TX389656502Medicaid