Provider Demographics
NPI:1063932028
Name:BOON, LAURA BETH (APRN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:BOON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:YANDELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:989500 NEBRASKA MEDICAL CTR FL CENTER5
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-9500
Mailing Address - Country:US
Mailing Address - Phone:402-559-4015
Mailing Address - Fax:402-559-8715
Practice Address - Street 1:989500 NEBRASKA MEDICAL CTR FL CENTER5
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-9500
Practice Address - Country:US
Practice Address - Phone:402-559-4015
Practice Address - Fax:402-559-8715
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112218363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care