Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 95010735 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN2319223 | MA |
NPI | 1003916636 |
---|---|
Provider Name | Laura Lynne Asaro |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 01/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110132668A | (05) | MA |
807569400 | (05) | ID |