Provider Demographics
NPI:1447634894
Name:STACE, LAURA BRITTON (MSN, RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BRITTON
Last Name:STACE
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MEMORIAL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:LURAY
Mailing Address - State:VA
Mailing Address - Zip Code:22835-1000
Mailing Address - Country:US
Mailing Address - Phone:540-843-4624
Mailing Address - Fax:
Practice Address - Street 1:250 MEMORIAL DR
Practice Address - Street 2:SUITE C
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835-1000
Practice Address - Country:US
Practice Address - Phone:703-477-0746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001263723163WP0200X
VA0024173476363LP0200X
NJ26NR17950300163W00000X
NY686228163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMS3871262OtherDEA