Laura Jean Wicker, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71001702A Issued in IN

Practice address

3554 Promenade Pkwy Ste B
Lafayette, IN 47909-8418

Phone

(574) 946-2194

Fax

(574) 946-2196

NPI assigned

Apr 12, 2006

Last updated

Apr 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Laura Jean Brown Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment NPD
• Phoenix Paramedic Solutions; LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lafayette, IN
  • NPI 1912766197
  Medicare reassignment NPD
• Union Healthcare Services Inc

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1013549468
  NPD
• Emergency Medicine of Indiana

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1952356883
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1114981842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3554 PROMENADE PKWY STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479098418",
            "telephone_number": "574-992-1226",
            "fax_number": "765-230-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3554 PROMENADE PKWY STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479098418",
            "telephone_number": "574-946-2194",
            "fax_number": "574-946-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKER",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001702A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BROWN",
            "middle_name": "JEAN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Uvie Christina Whiteru, MD
• Keith Randall Whitesides, MD
• Chelsea Whitfield, RBT
• Destini Whitfield, RBT
• Brittney Elizabeth Whittaker, LMHC
• Daniel J Wickert, M.D.
• Patricia Wickholm
• Brooke Widmer, MSW
• Patricia M Wilber, CST
• Lisa Wilder, ATC

• Family Nurse Practitioner in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.