Provider Demographics
NPI:1083684625
Name:SOFIELD, LAURA SUSAN II (RN, APN-C)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SUSAN
Last Name:SOFIELD
Suffix:II
Gender:F
Credentials:RN, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 HIGHWAY 35 N
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4051
Mailing Address - Country:US
Mailing Address - Phone:732-663-0099
Mailing Address - Fax:732-663-1359
Practice Address - Street 1:1205 HIGHWAY 35 N
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4051
Practice Address - Country:US
Practice Address - Phone:732-663-0099
Practice Address - Fax:732-663-1359
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00047400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0059781Medicaid
NJ083937QJVOtherMEDICARE-ID TYPE UNSPECIFIED
NJQ28169Medicare UPIN