Individual
MS. LAURA ANN SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2090 SMOKETREE AVE N, LAKE HAVASU CITY, AZ 86403
(928) 854-1800
(928) 854-1847
Mailing address
4811 COLORADO VIS, PARKER, AZ 85344-8655
(903) 746-0060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
761981
TX
363LF0000X
Family Nurse Practitioner
Primary
AP5734
AZ
363LF0000X
Family Nurse Practitioner
ARNP 9332948
FL
363LF0000X
Family Nurse Practitioner
SP010856
PA
Other
Enumeration date
08/02/2006
Last updated
07/15/2022
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