Individual
LAURA ANN LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP
Contact information
Practice address
3135 190TH ST, LANSING, IL 60438-3455
(218) 851-5101
Mailing address
3135 190TH ST, LANSING, IL 60438-3455
(218) 851-5101
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041446344
IL
163W00000X
Registered Nurse
28225021A
IN
363LF0000X
Family Nurse Practitioner
Primary
209020064
IL
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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