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NPI Code Detail

MEDICARE: LAURA HUSTON RN

MEDICARE: LAURA HUSTON RN
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
1163W00000XRegistered Nurse770273CA

General Provider Information

NPI Number : 1902430077
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA HUSTON RN
Provider Business Mailing Address
First Line : 10400 FRICOT CITY RD
Second Line :
City : SAN ANDREAS
State : CA
Zip : 95249-9642
Country : US
Telephone Number : 209-736-4500
Fax Number :
Provider Business Practice Location Address
First Line : 10400 FRICOT CITY RD
Second Line :
City : SAN ANDREAS
State : CA
Zip : 95249-9642
Country : US
Telephone Number : 209-736-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2020
Last Update Date : 02/27/2020

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