Provider Demographics
NPI:1770583791
Name:MCGATH, LAURA J (RN, CPNP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:J
Last Name:MCGATH
Suffix:
Gender:F
Credentials:RN, CPNP
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Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-483-7113
Mailing Address - Fax:757-483-7151
Practice Address - Street 1:4868 BRIDGE RD STE 310
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2048
Practice Address - Country:US
Practice Address - Phone:757-483-7113
Practice Address - Fax:757-483-7151
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209004858363LP0200X
VA0024177831363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics