Provider Demographics
NPI:1043819709
Name:LURZ CORDES, LAURA LEA (QSP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEA
Last Name:LURZ CORDES
Suffix:
Gender:F
Credentials:QSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 11TH AVE N
Mailing Address - Street 2:
Mailing Address - City:HETTINGER
Mailing Address - State:ND
Mailing Address - Zip Code:58639-7306
Mailing Address - Country:US
Mailing Address - Phone:701-567-6598
Mailing Address - Fax:
Practice Address - Street 1:300 11TH AVE N
Practice Address - Street 2:
Practice Address - City:HETTINGER
Practice Address - State:ND
Practice Address - Zip Code:58639-7306
Practice Address - Country:US
Practice Address - Phone:701-567-6598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant