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Individual
LAURA MARSAN
Active
Individual
LAURA MARSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28218777A
IN
363LF0000X
Family Nurse Practitioner
71005147A
IN
363LF0000X
Family Nurse Practitioner
Primary
COA 17343 NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000897864
ANTHEM PROVIDER NUMBER
IN
05
—
0147000
—
OH
05
—
201252970
—
IN
Enumeration date
09/24/2014
Last updated
07/13/2017
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