Healthcare Provider Details

I. General information

NPI: 1710251046
Provider Name (Legal Business Name): LAURA A SMITH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA A LONEHILL APRN

II. Dates (important events)

Enumeration Date: 03/05/2012
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5631 S 48TH ST STE 100
LINCOLN NE
68516
US

IV. Provider business mailing address

818 5TH AVE STE 200
DES MOINES IA
50309-1303
US

V. Phone/Fax

Practice location:
  • Phone: 877-811-7526
  • Fax: 515-280-7525
Mailing address:
  • Phone: 877-811-7526
  • Fax: 515-280-9525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF1088527
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number111335
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: