MEDICARE: LAURA DRIGGERS FNP-BC

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	363LF0000X	Family Nurse Practitioner	AP129879	TX

General Provider Information

NPI Number	:	1952757825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA DRIGGERS FNP-BC

Provider Business Mailing Address
First Line	:	605 EMBER LN
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-7666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 N IH 35 E STE 100
Second Line	:
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-5267
Country	:	US
Telephone Number	:	469-800-9500
Fax Number	:

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

Provider Enumeration Date	:	05/10/2016
Last Update Date	:	05/10/2016

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