Laura K. Henthorn, FNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

616612 Issued in TX

Practice address

3370 S Texas Ave
Suite B
Bryan, TX 77802-3127

Phone

(979) 595-1700

Fax

(979) 595-1740

NPI assigned

Sep 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Brazos Valley Community Action Agency, Inc.

  • Obstetrics Physician
  • College Station, TX
  • NPI 1811171580
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1740276591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E",
            "address_2": "#100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600",
            "telephone_number": "979-383-2340",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3370 S TEXAS AVE",
            "address_2": "SUITE B",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023127",
            "telephone_number": "979-595-1700",
            "fax_number": "979-595-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTHORN",
        "first_name": "LAURA",
        "middle_name": "K.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP110479",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "616612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI AGENCY",
            "identifier": "1821185299",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154467801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "741715140",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI CLINIC B",
            "identifier": "1649265646",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Minh-Phuong Henderson, D.D.S
• Latonya Hendricks, LPC, LSOTP
• Jeremy Robert Hendrickson, APRN
• Chalice Henry, PTA
• Melanie Hensley, DVM
• Adam Gregory Hepworth
• Arturo Heras
• Heritage Maternity Services
• John Herman
• Macey Victoria Hernandez

• Adult Health Nurse Practitioner in Bryan, TX
• Providers in Bryan, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.