Individual
MRS. LAURA ANN IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2208 S 17TH ST, WILMINGTON, NC 28401-7593
(910) 763-3333
(910) 763-3336
Mailing address
2208 S 17TH ST, WILMINGTON, NC 28401-7593
(910) 763-3333
(910) 763-3336
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03172
NC
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
0010-03172
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-03172
NC LICENSE NUMBER
NC
Enumeration date
10/19/2011
Last updated
03/06/2026
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