Healthcare Provider Details

I. General information

NPI: 1114481140
Provider Name (Legal Business Name): LAURA J. HANEY BA, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA I HUNTER

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 W PARK PL
COEUR D ALENE ID
83814-2785
US

IV. Provider business mailing address

107 S DIVISION ST
SPOKANE WA
99202-1510
US

V. Phone/Fax

Practice location:
  • Phone: 208-415-0299
  • Fax: 208-625-2070
Mailing address:
  • Phone: 509-838-4651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number58301
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number58301
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: