Provider Demographics
NPI:1962717827
Name:EDRINGTON, LAURA A (APN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:A
Last Name:EDRINGTON
Suffix:
Gender:F
Credentials:APN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7446 SHALLOWFORD RD
Mailing Address - Street 2:#104
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-8815
Mailing Address - Country:US
Mailing Address - Phone:423-443-3336
Mailing Address - Fax:
Practice Address - Street 1:7446 SHALLOWFORD RD
Practice Address - Street 2:#104
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-8815
Practice Address - Country:US
Practice Address - Phone:423-443-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15069363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519987Medicaid