Provider Demographics
NPI:1619701901
Name:ARDELEAN, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ARDELEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 BUTTERNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4202
Mailing Address - Country:US
Mailing Address - Phone:248-930-3492
Mailing Address - Fax:
Practice Address - Street 1:4011 BUTTERNUT HILL DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4202
Practice Address - Country:US
Practice Address - Phone:248-930-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider