MS. LAURA ANN SHACKELFORD (NPI# 1821005968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821005968 |
| Entity Type | Individual |
| Full Name | MS. LAURA ANN SHACKELFORD |
| Credential | ARNP |
| Practice Address |
2090 Smoketree Ave N Lake Havasu City AZ 86403 |
| Mailing Address |
Po Box 3630 Flagstaff AZ 86003-3630 |
| Practice Telephone | 9288541800 |
| Practice Fax Number | 9288541847 |
| Mailing Telephone | 9285229879 |
| Mailing Fax Number | 9285229880 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-01-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP5734 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP 9332948 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP010856 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
761981 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 89 Civic Center Ln, Lake Havasu City, AZ 864030810 | 9288546120 | 9288541398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003923210 | Laura J Shackelford | Psychologist | 219 Kent Rd Suite 14, New Milford, CT 06776-5528 | 2006-08-24 |
| Street Address |
2090 SMOKETREE AVE N |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700869302 | Mario Albert Torres | Internal Medicine | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2005-11-28 |
| 1932747870 | Ashley Renae Powell | Nurse Practitioner | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2019-12-10 |
| 1053582627 | Lakeview Family Health Care | Family Medicine | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2008-03-21 |
| 1578628293 | James M. De Laughter | Nurse Practitioner | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2006-12-22 |
| 1588697544 | Neal Patrick Patalinghug | Family Medicine | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403 | 2006-07-09 |
| 1114968310 | Lorraine R Byrd | Pediatrics | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2006-06-09 |
| 1104867308 | Kelli M Ward | Family Medicine | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2006-06-09 |
| 1548209950 | Sandra Marie Bronni | Pediatrics | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938860 | Family Primary Care, LLC | Nurse Practitioner | 84 Acoma Blvd N Ste 106, Lake Havasu City, AZ 86403-6096 | 2020-06-26 |
| 1568016368 | Anna Marie Samons | Nurse Practitioner | 2585 San Juan Dr, Lake Havasu City, AZ 86403-3151 | 2019-07-30 |
| 1891359915 | Lauren Huljev | Nurse Practitioner | 1720 Mesquite Ave Ste 100, Lake Havasu City, AZ 86403-5602 | 2019-04-24 |
| 1447631908 | Tammy Smith | Nurse Practitioner | 2091 Smoketree Ave N Ste 103, Lake Havasu City, AZ 86403-5896 | 2015-06-10 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1306270145 | Megan Michelle Randall | Nurse Practitioner | 2082 Mesquite Ave Ste 106a, Lake Havasu City, AZ 86403-6710 | 2013-08-28 |
| 1265745277 | Summer Yvonne Tilgner | Nurse Practitioner | 297 S. Lake Havasu Avenue, Ste 200, Lake Havasu City, AZ 86403 | 2010-07-19 |
| 1740815901 | Cassandra Kay Kyer | Nurse Practitioner | 1810 Mesquite Ave, Lake Havasu City, AZ 86403-5886 | 2020-03-09 |
| 1396370607 | Marie Annette Ohaver | Nurse Practitioner | 2664 Jamaica Blvd S, Lake Havasu City, AZ 86406-7712 | 2020-03-06 |
| 1932747870 | Ashley Renae Powell | Nurse Practitioner | 2090 Smoketree Ave N, Lake Havasu City, AZ 86403-5806 | 2019-12-10 |
| Find all providers in LAKE HAVASU CITY | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on MS. LAURA ANN SHACKELFORD.
| 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.