Provider Demographics
NPI:1902437940
Name:FALTAS, LAUREL ANNE (APRN)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:ANNE
Last Name:FALTAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24049 670TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-7613
Mailing Address - Country:US
Mailing Address - Phone:515-240-5128
Mailing Address - Fax:
Practice Address - Street 1:24049 670TH AVE
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-7613
Practice Address - Country:US
Practice Address - Phone:515-240-5128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA157734207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine