Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | CNP-02982 | NM |
NPI | 1093167330 |
---|---|
Provider Name | Laura K Merrigan |
First Address | Los Alamos, NM 87544-2275 |
Second Address | Los Alamos, NM 87544-2275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2016 |
Last Update Date | 11/07/2016 |