Individual
LAURA WRISLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 KENNEDY CT APT 16, TITUSVILLE, FL 32780-4060
(856) 213-8438
Mailing address
1111 KENNEDY CT APT 16, TITUSVILLE, FL 32780-4060
(856) 213-8438
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
NO3600-01
NY
164W00000X
Licensed Practical Nurse
353974-01
NY
Other
Enumeration date
01/03/2018
Last updated
09/29/2025
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