Provider Demographics
NPI:1447931613
Name:GAUSE, LAURA LEE (PA-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:GAUSE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:353 NEW SHACKLE ISLAND RD STE 140C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2366
Mailing Address - Country:US
Mailing Address - Phone:615-826-5664
Mailing Address - Fax:615-826-5665
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD STE 140C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2366
Practice Address - Country:US
Practice Address - Phone:615-826-5664
Practice Address - Fax:615-826-5665
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN6401363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant