Healthcare Provider Details

I. General information

NPI: 1043753312
Provider Name (Legal Business Name): LAURA LENARD WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 10/27/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 HEALTHCARE LOOP
CHARLOTTE NC
28215-7069
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-2319
  • Fax: 704-316-2321
Mailing address:
  • Phone: 704-384-7840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5009114
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number107394
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: