Provider Demographics
NPI:1962549741
Name:VON KANEL, LAURA WELLS (RN FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:WELLS
Last Name:VON KANEL
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:WELLS
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN/FNP
Mailing Address - Street 1:27518 CALVIN RD
Mailing Address - Street 2:
Mailing Address - City:HUFFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:77336-2901
Mailing Address - Country:US
Mailing Address - Phone:281-642-2706
Mailing Address - Fax:
Practice Address - Street 1:27518 CALVIN RD
Practice Address - Street 2:
Practice Address - City:HUFFMAN
Practice Address - State:TX
Practice Address - Zip Code:77336-2901
Practice Address - Country:US
Practice Address - Phone:281-642-2706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235174363LF0000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice