MEDICARE: DR. LAURA HOLLISTER-MEADOWS FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP30007335	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8861064	OTHER	WA	MEDICARE RHC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477534972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA HOLLISTER-MEADOWS FNP-BC

Provider Business Mailing Address
First Line	:	301 W POPLAR ST STE 220
Second Line	:
City	:	WALLA WALLA
State	:	WA
Zip	:	99362-2800
Country	:	US
Telephone Number	:	509-897-8300
Fax Number	:	509-897-6066

Provider Business Practice Location Address
First Line	:	301 W POPLAR ST STE 220
Second Line	:
City	:	WALLA WALLA
State	:	WA
Zip	:	99362-2800
Country	:	US
Telephone Number	:	509-897-8300
Fax Number	:	509-897-6066

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	11/13/2024

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Directions to “ DR. LAURA HOLLISTER-MEADOWS FNP-BC” Practice Location

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