Mason, Laura J
Mason, Laura J is an individual health care provider with primary practice located at 1995 E 17Th St Ste 2 , Idaho Falls ID 83404-6493. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mason, Laura J can be contacted via phone (208) 529-2352.Contact Information
Primary practice address
1995 E 17Th St Ste 2
Idaho Falls ID 83404-6493
Phone: (208) 529-2352
Fax: (208) 528-3332
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | NP386A | Idaho |
Profile Details
| NPI number | 1902980469 |
|---|---|
| LBN Legal business name | Mason, Laura J |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Feb 3rd, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902980469 | NPPES |
| Idaho | MEDICAID | 805725800 | |
| Idaho | Other | P00152836 |
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