Provider Demographics
NPI:1962593954
Name:VAN AUKER, LAURA L (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:VAN AUKER
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 1:10470 OLD PLACERVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:3133 PROFESSIONAL DR
Practice Address - Street 2:#20
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2463
Practice Address - Country:US
Practice Address - Phone:530-885-8821
Practice Address - Fax:530-885-6554
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP1505363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ15164ZMedicare ID - Type Unspecified
CAZZZ15164YMedicare PIN
S61468Medicare UPIN