Individual
MS. LAURIE LEE COLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4320 DIPLOMACY DR, ANCHORAGE, AK 99508-5925
(907) 729-2463
(907) 729-2362
Mailing address
5812 IMAN PARK CIRCLE, ROCKVILLE, MD 20852
(240) 330-9913
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R149149
MD
363LP0200X
Pediatric Nurse Practitioner
RN1005098
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4076982 00
—
MD
Enumeration date
03/27/2007
Last updated
09/06/2012
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