Provider Demographics
NPI:1043660749
Name:ANDREWS, LAURA (NURSE PRACTIONER)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37275 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-9782
Mailing Address - Country:US
Mailing Address - Phone:909-213-3130
Mailing Address - Fax:
Practice Address - Street 1:598 N F ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-3110
Practice Address - Country:US
Practice Address - Phone:909-888-8152
Practice Address - Fax:909-884-7530
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95004340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily