Provider Demographics
NPI:1861803496
Name:SHAUGHNESSY, LAURA (RNFA)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:SHAUGHNESSY
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:SHAUGHNESSY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNFA
Mailing Address - Street 1:PO BOX 110339
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37222-0339
Mailing Address - Country:US
Mailing Address - Phone:615-831-3711
Mailing Address - Fax:615-831-3713
Practice Address - Street 1:1810 TOLIVER TRCE
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4940
Practice Address - Country:US
Practice Address - Phone:615-831-3711
Practice Address - Fax:615-831-3713
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000149745163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant