Lisa Marie Laidlaw, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006925 Issued in CA

Practice address

104 Lynch Creek Way Ste 10
Petaluma, CA 94954-2355

Phone

(707) 782-9123

Fax

(707) 782-9622

NPI assigned

Dec 5, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1922513548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-525-6485",
            "fax_number": "707-573-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LYNCH CREEK WAY STE 10",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542355",
            "telephone_number": "707-782-9123",
            "fax_number": "707-782-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIDLAW",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95006925",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anita Lafollette, MFT
• Lakay Instead Home Care LLC
• Adamane S Lalith Mohan, M.D.
• Justin Brady Lalonde, PT
• Amanda Lam, MD
• Kiely Lam

• Family Nurse Practitioner in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.