LAURA MYERS HIERONYMUS


Address: 1700 Mishawaka Ave, Student Activity Center Rm 130, South Bend, IN 46634-7111
Phone: 5742505557

LAURA MYERS HIERONYMUS (NPI# 1922290790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922290790
Entity Type Individual
Full Name LAURA MYERS HIERONYMUS
Credential C.A.N.P.
Practice Address 1700 Mishawaka Ave
Student Activity Center Rm 130
South Bend
IN 46634-7111
Mailing Address 1700 Mishawaka Ave
Student Activity Center Rm 130, P.o. Box 7111
South Bend
IN 46615-1408
Practice Telephone 5742505557
Practice Fax Number 5745205042
Mailing Telephone 5742505557
Mailing Fax Number 5745205042
Enumeration Date 2007-08-15
Last Update Date 2007-08-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
NP02577 OH Physician Assistants & Advanced Practice Nursing Providers

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NPI Name Taxonomy Address Enumeration
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Office Location

Street Address 1700 MISHAWAKA AVE
STUDENT ACTIVITY CENTER RM 130
City SOUTH BEND
State IN
Zip Code 46634-7111

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811327943 Hibajene Chisonga Nurse Practitioner 1700 Mishawaka Ave, South Bend, IN 46634-7111 2013-11-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952721185 Indiana University South Bend Health & Wellness Center Licensed Practical Nurse 941 20th Street, South Bend, IN 46634-7111 2014-04-28

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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

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1740296516 Freda Ann Black Nurse Practitioner 112 W Jefferson Blvd, South Bend, IN 46601-1923 2006-07-31
1447721105 Daniela M Edson Nurse Practitioner 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 2018-12-06
1265810584 Tara Pousson Nurse Practitioner 112 W Jefferson Blvd, Suite 600, South Bend, IN 46601-1923 2015-05-07
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1033520101 Oluyinka Grace Osunnuga Nurse Practitioner 707 N Michigan St, Suite 400, South Bend, IN 46601-1067 2014-05-12
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Competitor

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City SOUTH BEND
Zip Code 46634

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Dataset Information

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.

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