Provider Demographics
NPI:1770729691
Name:THOMASSON, LAURI A (NP)
Entity type:Individual
Prefix:
First Name:LAURI
Middle Name:A
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:550 UNIVERSITY BLVD
Mailing Address - Street 2:RM 2041
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5149
Mailing Address - Country:US
Mailing Address - Phone:317-274-1640
Mailing Address - Fax:317-278-3787
Practice Address - Street 1:550 UNIVERSITY BLVD
Practice Address - Street 2:RM 2041
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-274-1640
Practice Address - Fax:317-278-3787
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2014-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71002785A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN896330002Medicare PIN