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General NPI Number Information
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NPI Number | 1265222012
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Entity Type | Organization
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Legal Business Name | LAURA L LARUE, APRN-BC, PLLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 100 GRAY ST
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2608
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Country | US
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Telephone | 270-317-0271
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Fax |
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Provider Business Mailing Address
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Address Line | 100 GRAY ST
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2608
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Country | US
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Telephone | 270-317-0271
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Fax |
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Authorized Official
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Title or Position | PMHNP/ FNP
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Name | LAURA L LARUE
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Credential | APRN-BC
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Telephone | 270-317-0271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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