MEDICARE: DR. NANCY ELAINE LAIDLAW AUD

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	231H00000X	Audiologist	35010043	MI

General Provider Information

NPI Number	:	1801818307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY ELAINE LAIDLAW AUD

Provider Business Mailing Address
First Line	:	4742 LAKESIDE BLVD
Second Line	:	PO BOX 616
City	:	HALE
State	:	MI
Zip	:	48739-8913
Country	:	US
Telephone Number	:	989-205-4342
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 BEECH ST STE C
Second Line	:
City	:	TAWAS CITY
State	:	MI
Zip	:	48763-8314
Country	:	US
Telephone Number	:	989-362-8196
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/08/2007

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