Logue, Laura J

Logue, Laura J is an individual health care provider with primary practice located at 1411 Laney Walker Blvd # An2206 Mcg Cancer Center, Augusta GA 30912-0002. 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. Logue, Laura J can be contacted via phone (706) 721-4811.

Contact Information

Primary practice address
1411 Laney Walker Blvd # An2206 Mcg Cancer Center Augusta GA 30912-0002
Phone: (706) 721-4811
Fax: (706) 721-0671
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN196130 NP Georgia

Profile Details

NPI number 1396899167
LBN Legal business name Logue, Laura J
Credentials Advanced Oncology Certified Nurse Practitioner (AOCNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Mar 17th, 2014 - about 11 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 1396899167 NPPES
Georgia MEDICAID 003104396B

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