Provider Demographics
NPI:1538772132
Name:SNEAD, LAURA GRANT (FNP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:GRANT
Last Name:SNEAD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 GODFREY RD
Mailing Address - Street 2:
Mailing Address - City:ELLERBE
Mailing Address - State:NC
Mailing Address - Zip Code:28338-8372
Mailing Address - Country:US
Mailing Address - Phone:472-203-6740
Mailing Address - Fax:910-384-5202
Practice Address - Street 1:1206 FULTON ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-1926
Practice Address - Country:US
Practice Address - Phone:472-203-6740
Practice Address - Fax:910-384-5202
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5013451OtherNC BOARD OF NURSING APPROVAL NUMBER