Provider Demographics
NPI:1518849678
Name:LAURENT, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:LAURENT
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 1:33 WALNUT ST APT 5
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4932
Mailing Address - Country:US
Mailing Address - Phone:862-224-7384
Mailing Address - Fax:
Practice Address - Street 1:33 WALNUT ST APT 5
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4932
Practice Address - Country:US
Practice Address - Phone:862-224-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR22779100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse