Herndon, Laurie

Herndon, Laurie is an individual health care provider with primary practice located at 630 Plantation St , Worcester MA 01605. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Herndon, Laurie can be contacted via phone (508) 595-2000.

Contact Information

Primary practice address
630 Plantation St Worcester MA 01605
Phone: (508) 595-2000
Fax: (508) 853-7149
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 187387 Massachusetts

Profile Details

NPI number 1225002512
LBN Legal business name Herndon, Laurie
Credentials Gerontological Nurse Practitioner (GNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225002512 NPPES
Massachusetts MEDICAID 0700711
Massachusetts Other 042472266008
Massachusetts Other NP0660
Massachusetts Other 04247226
Massachusetts Other NP0660
Massachusetts Other 0700711
Massachusetts Other 57676
Massachusetts Other NP0660
Massachusetts Other NP0660
Massachusetts Other 8300302
Massachusetts Other AA3450

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