Healthcare Provider Details

I. General information

NPI: 1114199742
Provider Name (Legal Business Name): LAURA ELIZABETH FUHRMAN-RHODES RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 EAST 23RD AVENUE SUITE 200
FREMONT NE
68025
US

IV. Provider business mailing address

1034 NORTH BROADWAY
COUNCIL BLUFFS IA
51503
US

V. Phone/Fax

Practice location:
  • Phone: 866-784-2329
  • Fax:
Mailing address:
  • Phone: 402-630-8531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number114152
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 714538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: