Provider Demographics
NPI:1891486775
Name:ANTHONY, LAURA LEE (NP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEE
Last Name:ANTHONY
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 1:3783 CARVETTE CT
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9707
Mailing Address - Country:US
Mailing Address - Phone:336-870-2828
Mailing Address - Fax:
Practice Address - Street 1:100 AIRPORT RD FL 4
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1604
Practice Address - Country:US
Practice Address - Phone:252-522-7197
Practice Address - Fax:252-522-7250
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018177363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal