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General NPI Number Information
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NPI Number | 1770729691
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Entity Type | Individual
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Provider Name | LAURI A THOMASSON NP
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Gender | Female
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 04/11/2014
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Provider Practice Location Address
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Address Line | 550 UNIVERSITY BLVD RM 2041
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5149
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Country | US
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Telephone | 317-274-1640
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Fax | 317-278-3787
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Provider Business Mailing Address
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Address Line | 550 UNIVERSITY BLVD RM 2041
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5149
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Country | US
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Telephone | 317-274-1640
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Fax | 317-278-3787
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 71002785A
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License Number State | IN
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