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Individual

DR. LAURA JANE DELERUYELLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP

Contact information

Practice address
3144 STATE ST, MEDFORD, OR 97504-8450
(541) 773-9772
(541) 773-1113
Mailing address
3144 STATE ST, MEDFORD, OR 97504-8450
(541) 773-9772
(541) 773-1113

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP2859852
FL
363LF0000X
Family Nurse Practitioner
Primary
201709802NP
OR
363LF0000X
Family Nurse Practitioner
5004960
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Y8929
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
05/30/2007
Last updated
03/17/2018
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