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Individual
LAURA ASHLEY LOGAN
Active
Individual
LAURA ASHLEY LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.473303
IL
163W00000X
Registered Nurse
225340
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.018539
IL
Other
Enumeration date
12/10/2018
Last updated
02/13/2020
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