LAURA L WAVRA (NPI# 1003876434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003876434 |
| Entity Type | Individual |
| Full Name | LAURA L WAVRA |
| Credential | NP |
| Practice Address |
124 Sagamore Pkwy W West Lafayette IN 47906-1569 |
| Practice Telephone | 7654636722 |
| Practice Fax Number | 7654630905 |
| Mailing Telephone | 7654636722 |
| Mailing Fax Number | 7654630905 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2012-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71001832A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71001832A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200506050 | 05 |
| Street Address |
124 SAGAMORE PKWY W |
| City | WEST LAFAYETTE |
| State | IN |
| Zip Code | 47906-1569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326076530 | John K Randall | Dermatology | 124 Sagamore Pkwy W, West Lafayette, IN 47906-1569 | 2006-06-28 |
| 1164459863 | Katrina N Masterson | Nurse Practitioner | 124 Sagamore Pkwy W, West Lafayette, IN 47906-1569 | 2006-06-27 |
| 1790711828 | Theresa E Coyner | Nurse Practitioner | 124 Sagamore Pkwy W, West Lafayette, IN 47906-1569 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457990848 | Wickshire West Lafayette Opco LLC | Assisted Living Facility | 3575 Senior Place, West Lafayette, IN 47906 | 2020-01-02 |
| 1992290530 | Cameron Eldred | Specialist/Technologist | 3367 Edison Dr, West Lafayette, IN 47906 | 2018-06-26 |
| 1720593403 | Devin Kay Hall | Specialist/Technologist | 900 John R. Wooden Drive, West Lafayette, IN 47906 | 2017-12-04 |
| 1609398270 | Christian Floirendo | Specialist/Technologist | 2225 Willowbrook Dr, #207, West Lafayette, IN 47906 | 2017-07-14 |
| 1699176800 | Leslie Michell Pell | Registered Nurse | 1873 Kingeider Drive, West Lafayette, IN 47906 | 2014-09-07 |
| 1881007581 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 2636 Us52 Sagamore Pkwy, West Lafayette, IN 47906 | 2014-06-10 |
| 1588089536 | Sarah Pierce | Pharmacist | 2636 Us 52, West Lafayette, IN 47906 | 2014-02-27 |
| 1811228240 | Angelica D. Kokkalis | Acupuncturist | 124 Westwood Dr., W. Lafayette, IN 47906 | 2010-01-25 |
| 1255529335 | Greater Lafayette Health Services | Clinic/Center | 3482 Mcclure Ave, West Lafayette, IN 47906 | 2007-10-15 |
| 1871784330 | Sally A Timmons LLC | Social Worker | 120 Sagamore Parkway West, West Lafayette, IN 47906 | 2007-08-08 |
| Find all providers in zip 47906 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285274464 | Christine Michelle Jones | Nurse Practitioner | Lyles-porter Hall 715 Clinic Drive, West Lafayette, IN 47907 | 2020-01-15 |
| 1700424819 | Abbi Marie Pena | Nurse Practitioner | 909 Sagamore Pkwy W, West Lafayette, IN 47906-1443 | 2019-12-19 |
| 1598267403 | Nisha Bogosian | Nurse Practitioner | 1400 W State St Ste B, West Lafayette, IN 47906-3438 | 2018-03-06 |
| 1285095885 | Christina Ellen Manfred | Nurse Practitioner | 601 W. Stadium Ave, West Lafayette, IN 47907 | 2016-03-10 |
| 1871896654 | Michelle Renee Thompson | Nurse Practitioner | 512 Sagamore Pkw W, West Lafayette, IN 47906-1819 | 2010-12-16 |
| 1528071404 | Beth Ann Taylor | Nurse Practitioner | 1400 West State Street, Bldg B, Ste C, West Lafayette, IN 47906 | 2006-08-14 |
| 1992280960 | Carol Callahan Lancaster | Nurse Practitioner | 601 Stadium Mall Drive, West Lafayette, IN 47907 | 2018-09-26 |
| 1225511033 | Ashley Mundil | Nurse Practitioner | 512 Sagamore Pkwy W, West Lafayette, IN 47906-1458 | 2018-09-09 |
| 1376060962 | Kimberly Ann Pauline Porter | Nurse Practitioner | 1400 W State St Ste C, West Lafayette, IN 47906-3438 | 2017-08-24 |
| 1649795766 | Katie M Neal | Nurse Practitioner | 915 Sagamore Pkwy W, West Lafayette, IN 47906-1443 | 2017-08-09 |
| Find all providers in WEST LAFAYETTE | ||||
| City | WEST LAFAYETTE |
| Zip Code | 47906 |
Please comment or provide details below to improve the information on LAURA L WAVRA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.