LAURA KALEIGH MUNDY (NPI# 1538520812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538520812 |
| Entity Type | Individual |
| Full Name | LAURA KALEIGH MUNDY |
| Credential | FNP-BC |
| Practice Address |
2500 Jacksboro Pike Ste 6 Jacksboro TN 37757-2818 |
| Mailing Address |
440 Walden Ln La Follette TN 37766-5026 |
| Practice Telephone | 4233526500 |
| Mailing Telephone | (423) 201-9937 |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2017-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0000021023 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2500 JACKSBORO PIKE STE 6 |
| City | JACKSBORO |
| State | TN |
| Zip Code | 37757-2818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700419090 | Amanda Ashley Thomas | Nurse Practitioner | 2500 Jacksboro Pike Ste 6, Jacksboro, TN 37757-2818 | 2020-02-15 |
| 1972043214 | Eastlake Primary Care LLC | Clinic/Center | 2500 Jacksboro Pike Ste 6, Jacksboro, TN 37757-2818 | 2017-03-06 |
| 1467992446 | Eastlake Medical, LLC | Clinic/Center | 2500 Jacksboro Pike Ste 6, Jacksboro, TN 37757-2818 | 2017-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861809642 | Samantha Ross | Physical Therapy Assistant | 272 Gardner Lane, Jacksboro, TN 37757 | 2014-07-14 |
| 1225348493 | Summit Medical Group, Pllc | Internal Medicine | 163 Perkins Lane, Jacksboro, TN 37757 | 2010-10-20 |
| 1518112911 | Pediatric Professionals | Specialist | 136 Mountain Perkins Lane, Suite 2, Jacksboro, TN 37757 | 2008-11-26 |
| 1992804827 | Riggs Drug Store | Pharmacy | 2636 Jacksboro Pike, Jacksboro, TN 37757 | 2006-09-21 |
| 1629536362 | Jacksboro Urgent Care | Clinic/Center | 2707 Jacksboro Pike, Suite 2, Jacksboro, TN 37757 | 2019-03-12 |
| 1942598305 | Thomas Wayne Robbins | Family Medicine | 2545 Jacksboro Pike, Jacksboro, TN 37757 | 2011-07-19 |
| 1841514155 | Margaret Reid Young | Nurse Practitioner | 136 Mountain Perkins Lane, Suite 2, Jacksboro, TN 37757 | 2010-03-16 |
| 1962540880 | State of Tennessee | Public Health or Welfare | 162 Sharp Perkins Road, Jacksboro, TN 37757 | 2007-02-02 |
| 1083868517 | Med-trans Corporation | Ambulance | 588 Memorial Lane, Jacksboro, TN 37757-0000 | 2008-11-11 |
| 1780722975 | Wanda F Tackett | Registered Nurse | 162 Sharp Perkins Road, Jacksboro, TN 37757-0418 | 2007-02-01 |
| Find all providers in zip 37757 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598274128 | Suzzan Bea Fleming | Nurse Practitioner | 1620 Fm 3344, Jacksboro, TX 76458 | 2017-09-27 |
| 1386093060 | Brittany Paige Smith | Nurse Practitioner | 2707 Jacksboro Pike Ste 2, Jacksboro, TN 37757-2752 | 2016-06-03 |
| 1841514957 | Patricia Ann Eberharter | Nurse Practitioner | 2707 Jacksboro Pike Ste 1a, Jacksboro, TN 37757-2752 | 2010-03-18 |
| 1780907238 | Pamela G Davis | Nurse Practitioner | 281 Paradise Ln, Jacksboro, TN 37757-3931 | 2010-03-11 |
| 1447875166 | Jennifer Riley | Nurse Practitioner | 2702 Jacksboro Pike, Jacksboro, TN 37757-4850 | 2020-06-09 |
| 1225652720 | Katherine Gresham | Nurse Practitioner | 2702 Jacksboro Pike, Jacksboro, TN 37757-4850 | 2020-06-01 |
| 1700419090 | Amanda Ashley Thomas | Nurse Practitioner | 2500 Jacksboro Pike Ste 6, Jacksboro, TN 37757-2818 | 2020-02-15 |
| 1750922902 | Jennifer Maria Muggridge | Nurse Practitioner | 2702 Jacksboro Pike, Jacksboro, TN 37757-4850 | 2019-09-30 |
| 1780185686 | Sandra Renee Bond | Nurse Practitioner | 2707 Jacksboro Pike Ste 1a, Jacksboro, TN 37757-2752 | 2018-02-26 |
| 1326590175 | Amy Young | Nurse Practitioner | 2702 Jacksboro Pike, Jacksboro, TN 37757-4850 | 2016-10-27 |
| Find all providers in JACKSBORO | ||||
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| 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.