Individual
LALAURA LOUISE LOGAN-THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1441 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1707
(563) 383-1900
(563) 328-5690
Mailing address
1613 12TH ST, ROCK ISLAND, IL 61201-3444
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041387210
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G177211
IA
Other
Enumeration date
07/29/2021
Last updated
12/28/2023
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