Healthcare Provider Details

I. General information

NPI: 1700322898
Provider Name (Legal Business Name): LAURA ADDISON SYKORA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DRIVE MASTIN 101
MOBILE AL
36617-2300
US

IV. Provider business mailing address

24495 POWELL RD
LOXLEY AL
36551-8537
US

V. Phone/Fax

Practice location:
  • Phone: 251-445-8282
  • Fax: 251-445-8281
Mailing address:
  • Phone: 251-269-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-074419
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: