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General NPI Number Information
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NPI Number | 1538772132
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Entity Type | Individual
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Provider Name | LAURA GRANT SNEAD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 1206 FULTON ST
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City | RAEFORD
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State | NC
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Zip | 28376-1926
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Country | US
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Telephone | 472-203-6740
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Fax | 910-384-5202
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Provider Business Mailing Address
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Address Line | 219 GODFREY RD
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City | ELLERBE
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State | NC
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Zip | 28338-8372
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Country | US
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Telephone | 472-203-6740
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Fax | 910-384-5202
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5013451
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License Number State | NC
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