Provider Demographics
NPI:1760287700
Name:PAUP JOHNSON, LAURIE RENEE (RN, NHA)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:RENEE
Last Name:PAUP JOHNSON
Suffix:
Gender:F
Credentials:RN, NHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 W 2ND ST STE LL200
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5420
Mailing Address - Country:US
Mailing Address - Phone:308-833-3981
Mailing Address - Fax:308-382-0589
Practice Address - Street 1:1811 W 2ND STREET LL200
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803
Practice Address - Country:US
Practice Address - Phone:308-833-3981
Practice Address - Fax:308-382-0589
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE43960163W00000X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse