Provider Demographics
NPI:1144511205
Name:NUNNO, LAURA VIRGINIA (DC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:VIRGINIA
Last Name:NUNNO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BERLIN RD
Mailing Address - Street 2:#114
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-2633
Mailing Address - Country:US
Mailing Address - Phone:860-635-6913
Mailing Address - Fax:860-635-0169
Practice Address - Street 1:75 BERLIN RD
Practice Address - Street 2:#114
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-2633
Practice Address - Country:US
Practice Address - Phone:860-635-6913
Practice Address - Fax:860-635-0169
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT574111N00000X
IA574111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor