Provider Demographics
NPI:1861225229
Name:HARRIOTT, LAURA G (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:G
Last Name:HARRIOTT
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PARK AVE SW
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3835
Mailing Address - Country:US
Mailing Address - Phone:803-761-6170
Mailing Address - Fax:803-761-6171
Practice Address - Street 1:118 PARK AVE SW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3835
Practice Address - Country:US
Practice Address - Phone:803-761-6170
Practice Address - Fax:803-761-6171
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003342363LA2100X
SC30050363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care