Antoinette Laura, NP
Nurse Practitioner in Wilmington, CA. Individual provider (NPI-1).
NPI number1629045752
StatusActive
Last updated in NPPESOct 29, 2013
Details
- NPI
- 1629045752
- Entity type
- Individual (NPI-1)
- Name
- Antoinette Laura
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 7, 2006
- Last updated
- Oct 29, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 8978 | CA | Yes |
Practice location
1009 N Avalon BlvdWilmington, CA 90744-4505
Phone 310-549-5760
Mailing address
1009 N Avalon BlvdWilmington, CA 90744-4505
Phone 310-549-5760
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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