Provider Demographics
NPI:1992301584
Name:POWELL, LAURA RENEE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:RENEE
Last Name:POWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:RENEE
Other - Last Name:WESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18718 EVANHALE BEND DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-7781
Mailing Address - Country:US
Mailing Address - Phone:713-410-4816
Mailing Address - Fax:
Practice Address - Street 1:18718 EVANHALE BEND DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7781
Practice Address - Country:US
Practice Address - Phone:713-410-4816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily