Provider Demographics
NPI:1699204867
Name:MONETTE-WOOD, LAURA M (LPN)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:MONETTE-WOOD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:MONETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:7015 SPRING MEADOWS WEST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528
Mailing Address - Country:US
Mailing Address - Phone:419-491-1180
Mailing Address - Fax:419-491-1181
Practice Address - Street 1:7015 SPRING MEADOWS WEST
Practice Address - Street 2:SUITE 102
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528
Practice Address - Country:US
Practice Address - Phone:419-491-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN154217MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse