Healthcare Provider Details

I. General information

NPI: 1861695066
Provider Name (Legal Business Name): LAURA MAGNHILD FRANCIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EAGLE AVE
OCEAN NJ
07712-7631
US

IV. Provider business mailing address

1200 EAGLE AVE
OCEAN NJ
07712-7631
US

V. Phone/Fax

Practice location:
  • Phone: 732-660-6200
  • Fax: 732-660-6201
Mailing address:
  • Phone: 732-660-6200
  • Fax: 732-660-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00169100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP009242
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: