Healthcare Provider Details
I. General information
NPI: 1013013747
Provider Name (Legal Business Name): LAURA C HEARD RN, MS, CRRN-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1660 S COLUMBIAN WAY #128
SEATTLE WA
98108-1532
US
IV. Provider business mailing address
4245 NE 74TH ST
SEATTLE WA
98115-6035
US
V. Phone/Fax
- Phone: 206-277-3302
- Fax: 206-764-2799
- Phone: 206-525-0965
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364S00000X |
| Taxonomy | Clinical Nurse Specialist |
| License Number | RN00045989 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: