Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 9217834 | FL |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN9217834 | FL |
NPI | 1023355278 |
---|---|
Provider Name | Laurie Kupersmith |
First Address | Sunrise, FL 33323-3207 |
Second Address | Sunrise, FL 33323-3207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2013 |
Last Update Date | 03/04/2019 |