Provider Demographics
NPI:1518755925
Name:MCELDERRY, LAURA RENEE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RENEE
Last Name:MCELDERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 CHAPEL RIDGE LN APT 3
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-8571
Mailing Address - Country:US
Mailing Address - Phone:531-255-2053
Mailing Address - Fax:
Practice Address - Street 1:15113 S 17TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-6830
Practice Address - Country:US
Practice Address - Phone:402-686-7604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant