Provider Demographics
NPI:1144897034
Name:ALVIN, LAURA ANN (RN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:ALVIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7735 CRAWLING STONE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2481
Mailing Address - Country:US
Mailing Address - Phone:608-598-0262
Mailing Address - Fax:
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-2429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI141393-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse