Individual
LAURA NITAHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 982-3188
Mailing address
2050 CLAIRE CT, GLENVIEW, IL 60025-7635
(844) 656-8763
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209019202
IL
Other
Enumeration date
01/16/2020
Last updated
08/02/2023
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