Provider Demographics
NPI:1962961979
Name:LARUE, LAURA L (APRN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:LARUE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 WOODLAND DR STE A
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2642
Mailing Address - Country:US
Mailing Address - Phone:270-900-1825
Mailing Address - Fax:270-900-1414
Practice Address - Street 1:1345 WOODLAND DR STE A
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2642
Practice Address - Country:US
Practice Address - Phone:270-900-1825
Practice Address - Fax:270-900-1414
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013228363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily