MEDICARE: MRS. LAURIE ELIZABETH PAGE APRN

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	5019706	NC
2	363L00000X	Nurse Practitioner	5019706	NC

General Provider Information

NPI Number	:	1770340291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURIE ELIZABETH PAGE APRN

Provider Business Mailing Address
First Line	:	500 PINEVIEW DR STE 205
Second Line	:
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-3814
Country	:	US
Telephone Number	:	336-329-3295
Fax Number	:

Provider Business Practice Location Address
First Line	:	855 SAM NEWELL RD STE 204
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-7594
Country	:	US
Telephone Number	:	980-202-6643
Fax Number	:	980-246-9482

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

Provider Enumeration Date	:	03/01/2024
Last Update Date	:	04/10/2025

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