Laura C Niewenhous, CRNP

Key facts

NPI

1508948324

Entity type

Individual (NPI type 1)

Primary specialty

Gerontology Nurse Practitioner 363LG0600X

License

R062554 (MD)

Practice address

134 Owensville Rd
West River, MD 20778-9998

Phone

(410) 867-4700

Fax

(410) 867-4934

NPI assigned

Oct 20, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 2

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

• Owensville Primary Care, Inc Family Medicine Physician · West River, MD · NPI 1225110067
  NPD (past) GERONTOLOGY
• Owensville Primary Care,Inc Federally Qualified Health Center (FQHC) · Lothian, MD · NPI 1942875026
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508948324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 STONELEIGH CT",
            "city": "HUNTINGTOWN",
            "state": "MD",
            "postal_code": "206399751",
            "telephone_number": "301-494-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 OWENSVILLE RD",
            "city": "WEST RIVER",
            "state": "MD",
            "postal_code": "207789998",
            "telephone_number": "410-867-4700",
            "fax_number": "410-867-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEWENHOUS",
        "first_name": "LAURA",
        "middle_name": "C",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R062554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West River, MD

• Jonathan J Hennessee, D.O.
• Angela Renee Liston, OTR/L
• Bonnie Jeanne McDonald
• Daphne Metellus, MD
• Gbemisola Elizabeth Mojelope, PMHNP-BC
• Catherine Njiru-Sewer, D.O.
• Patricia N Nowell, LCPC
• Owensville Primary Care, Inc
• Lenisha M Paige, PA-C
• Andrew Alexander Powell

All providers in West River, MD · Gerontology Nurse Practitioner in Maryland