Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 83513 | NC |
N | 111NI0900X | Internist | 83513 | NC |
Y | 207RN0300X | Nephrologist | 83513 | NC |
NPI | 1023017563 |
---|---|
Provider Name | Dr. Denise H. Laurienti |
First Address | Winston Salem, NC 27103-7108 |
Second Address | Winston-Salem, NC 27103-7108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136NJ | BCBS (01) | NC |
89136NJ | (05) | NC |
I06883 | (02) | NC |