Healthcare Provider Details

I. General information

NPI: 1801211776
Provider Name (Legal Business Name): LAURA ASHLEY DAVID NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S 17TH ST
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

200 HAWTHORNE LN
CHARLOTTE NC
28204-2515
US

V. Phone/Fax

Practice location:
  • Phone: 910-667-7360
  • Fax:
Mailing address:
  • Phone: 704-384-4944
  • Fax: 704-384-5612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5006779
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number5006779
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number5006779
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: