Provider Demographics
NPI:1528497229
Name:BREDT, LAURA COOK (RN)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:COOK
Last Name:BREDT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:KATHLEEN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1001 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6100
Mailing Address - Country:US
Mailing Address - Phone:512-863-1252
Mailing Address - Fax:
Practice Address - Street 1:1001 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6100
Practice Address - Country:US
Practice Address - Phone:512-863-1252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX551149163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse