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General NPI Number Information
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NPI Number | 1952550261
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Entity Type | Individual
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Provider Name | LAURA JEANNE PACINI AU.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 256 N 2ND E STE 3
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City | REXBURG
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State | ID
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Zip | 83440-1638
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Country | US
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Telephone | 208-356-0766
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Fax |
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Provider Business Mailing Address
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Address Line | 256 N 2ND E STE 3
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City | REXBURG
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State | ID
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Zip | 83440-1638
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Country | US
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Telephone | 208-356-0766
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A.01663
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD-5912
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License Number State | ID
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