Staub, Laurie M.

Staub, Laurie M. is an individual health care provider with primary practice located at 725 Jesse Jewell Pkwy Se , Gainesville GA 30501-3834. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Staub, Laurie M. can be contacted via phone (770) 534-1986.

Contact Information

Primary practice address
725 Jesse Jewell Pkwy Se Gainesville GA 30501-3834
Phone: (770) 534-1986
Fax: (770) 297-5645
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R081873 Georgia

Profile Details

NPI number 1790730042
LBN Legal business name Staub, Laurie M.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Apr 23rd, 2021 - about 3 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 1790730042 NPPES
Georgia Other 500020776 RR MEDICARE-GRP # CC4177
Georgia MEDICAID 000706384A RR MEDICARE-GRP # CC4177
Georgia Other 10053490 RR MEDICARE-GRP # CC4177
Georgia Other 335920 RR MEDICARE-GRP # CC4177

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