Provider Demographics
NPI:1861953275
Name:LAFFORGUE, MICOLE ANDREIA (FNP-BC)
Entity type:Individual
Prefix:
First Name:MICOLE
Middle Name:ANDREIA
Last Name:LAFFORGUE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MICOLE
Other - Middle Name:ANDREIA
Other - Last Name:STRINGFELLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3917 GEORGETOWN RD NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-1806
Mailing Address - Country:US
Mailing Address - Phone:423-813-3830
Mailing Address - Fax:423-402-8550
Practice Address - Street 1:3917 GEORGETOWN RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312
Practice Address - Country:US
Practice Address - Phone:423-813-3830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily