Individual
MRS. LAURIE CONROE MOUSAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
49 LAWRENCE AVE, POTSDAM, NY 13676
(315) 261-2153
(315) 265-2540
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 265-3300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
349218
NY
367A00000X
Advanced Practice Midwife
Primary
F0009701
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02146830
—
NY
Enumeration date
01/04/2006
Last updated
08/30/2018
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