Provider Demographics
NPI:1811050974
Name:SMITH, LAURA D (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:D
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PEARSON DR
Mailing Address - Street 2:
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922-1427
Mailing Address - Country:US
Mailing Address - Phone:978-465-3750
Mailing Address - Fax:
Practice Address - Street 1:50 MANSION DR
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-1026
Practice Address - Country:US
Practice Address - Phone:978-948-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0386430Medicaid
MAS31568Medicare UPIN
MA0386430Medicaid