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Individual
TARA ANNE LEE LAUREANO
Active
Individual
TARA ANNE LEE LAUREANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16302
CA
363LP0200X
Pediatric Nurse Practitioner
NP16302
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN651397
—
CA
Enumeration date
07/27/2006
Last updated
10/24/2024
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