Individual
HOLLY LAUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2200 N SECTION ST, SULLIVAN, IN 47882-7523
(812) 268-4311
(812) 268-6809
Mailing address
PO BOX 10, SULLIVAN, IN 47882-0010
(812) 268-4311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004904A
IN
363LF0000X
Family Nurse Practitioner
71004904A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000895639
ANTHEM
IN
05
—
201234250
—
IN
Enumeration date
05/28/2014
Last updated
09/06/2023
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