Individual provider Active NPI

Marie Gerda Laurent, LPN

  • Licensed Practical Nurse
  • Palm Bay, FL
National Provider Identifier
1306367446
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5187723 Issued in FL
Practice address
1801 Thorman Ave SE
Palm Bay, FL 32909-5764
Phone
(321) 960-0957
Fax
(321) 960-0957
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 5187723PN FL
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X PN5187723 FL Primary

Addresses

Primary practice location

1801 Thorman Ave SE
Palm Bay, FL 32909-5764

Mailing address

1801 Thorman Ave SE
Palm Bay, FL 32909-5764
Phone (321) 960-0957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN5187723FLMDLicensed Practical Nurse
5187723PNFLMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1306367446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 THORMAN AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329095764",
            "telephone_number": "321-960-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 THORMAN AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329095764",
            "telephone_number": "321-960-0957",
            "fax_number": "321-960-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENT",
        "first_name": "MARIE",
        "middle_name": "GERDA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "5187723PN",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5187723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.