Hackworth, Laura Lorraine

Hackworth, Laura Lorraine is an individual health care provider with primary practice located at 510 Fullerton Rd , Swansea IL 62226-2970. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Hackworth, Laura Lorraine can be contacted via phone (618) 233-7666.

Contact Information

Primary practice address
510 Fullerton Rd Swansea IL 62226-2970
Phone: (618) 233-7666
Fax: (618) 233-7461
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209006150 Illinois

Profile Details

NPI number 1295849032
LBN Legal business name Hackworth, Laura Lorraine
Credentials APRN,CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Oct 13th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295849032 NPPES
Illinois MEDICAID 209006150
Illinois Other P00372772

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