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General NPI Number Information
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NPI Number | 1124178173
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Entity Type | Individual
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Provider Name | MS. LAURA SUBEL MCLOUGHLIN
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 225 N PINE ST STE E
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City | GUNNISON
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State | CO
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Zip | 81230-2648
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Country | US
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Telephone | 970-641-0209
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 696 725 RED LADY AVE.
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City | CRESTED BUTTE
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State | CO
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Zip | 81224-0696
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Country | US
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Telephone | 970-349-6847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 163228
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License Number State | CO
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