Provider Demographics
NPI:1730291634
Name:DUKE, LAURA A (ARNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:DUKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:224 SE 24TH ST
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32602
Mailing Address - Country:US
Mailing Address - Phone:352-334-7900
Mailing Address - Fax:352-334-7937
Practice Address - Street 1:ACHD 224 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641
Practice Address - Country:US
Practice Address - Phone:352-334-7900
Practice Address - Fax:352-334-7937
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN0993882163W00000X
FLAN099388C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03339130Medicaid
E0301Medicare ID - Type Unspecified
S50652Medicare UPIN