Healthcare Provider Details

I. General information

NPI: 1326722760
Provider Name (Legal Business Name): LAURA HORAN CAPAROSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3643 N ROXBORO ST
DURHAM NC
27704-2702
US

IV. Provider business mailing address

424 JEROME RD
DURHAM NC
27713-1290
US

V. Phone/Fax

Practice location:
  • Phone: 919-470-4000
  • Fax:
Mailing address:
  • Phone: 724-968-6266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5018258
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: