MEDICARE: LAURA V SETTLAGE PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	745526	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP123459	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	013905	OTHER	TX	PRESCRIPTION ID

General Provider Information

NPI Number	:	1750726345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA V SETTLAGE PMHNP

Provider Business Mailing Address
First Line	:	5222 WHISPERING OAKS DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75236-1740
Country	:	US
Telephone Number	:	940-636-7834
Fax Number	:	940-293-9911

Provider Business Practice Location Address
First Line	:	5222 WHISPERING OAKS DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75236-1740
Country	:	US
Telephone Number	:	940-636-7834
Fax Number	:	940-293-9911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	04/21/2017

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