Provider Demographics
NPI:1164511366
Name:LAUGESEN, CATHERINE ANN (CRNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:LAUGESEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:JUDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9800 SAVAGE RD
Mailing Address - Street 2:SUITE 6404
Mailing Address - City:FORT GEORGE G MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755-5999
Mailing Address - Country:US
Mailing Address - Phone:301-688-7264
Mailing Address - Fax:
Practice Address - Street 1:9800 SAVAGE RD
Practice Address - Street 2:SUITE 6404
Practice Address - City:FORT GEORGE G MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755-5999
Practice Address - Country:US
Practice Address - Phone:410-744-0898
Practice Address - Fax:410-744-2007
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR140770363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD027108000Medicaid
MD169128Y56OtherMEDICARE PTAN