Healthcare Provider Details

I. General information

NPI: 1518327774
Provider Name (Legal Business Name): LAURA ASHFORD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 NEW BERN AVE
RALEIGH NC
27610-1231
US

IV. Provider business mailing address

3100 SPRING FOREST RD
RALEIGH NC
27616-2880
US

V. Phone/Fax

Practice location:
  • Phone: 919-873-9533
  • Fax: 919-882-7913
Mailing address:
  • Phone: 919-350-5645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number243326
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5008620
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: