LAURA B WILLARD AGACNP-BC NPI 1700314754

NPI Information

NPI: 1700314754
Provider Name: LAURA B WILLARD, AGACNP-BC
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: CARDIOLOGY CONSULTANTS PA

PECOS Registration: Yes

Address:
1083 BOILING SPRINGS RD
SPARTANBURG, SC
ZIP 29303
Phone: (864) 583-8647
Get Directions

Laura B Willard, AGACNP-BC is a gerontology nurse practitioner in Spartanburg, SC with 7 years of experience. Laura B Willard, AGACNP-BC NPI is 1700314754. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1083 BOILING SPRINGS RD
SPARTANBURG, SC
ZIP 29303-248
Phone: (864) 583-8647

The NPI 1700314754 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2017 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	21035	SOUTH CAROLINA	No
2	363LG0600X	Nurse Practitioner	Gerontology	21035	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	21035	OTHER	SOUTH CAROLINA	SC MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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