Healthcare Provider Details

I. General information

NPI: 1174564249
Provider Name (Legal Business Name): LAURA RENEE MAYER C ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. LAURA RENNE WRIGHT

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4270 US ROUTE 60
HUNTINGTON WV
25705-2936
US

IV. Provider business mailing address

PO BOX 1680
HUNTINGTON WV
25717-1680
US

V. Phone/Fax

Practice location:
  • Phone: 304-781-3610
  • Fax: 304-781-3611
Mailing address:
  • Phone: 304-781-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number65080
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: