Provider Demographics
NPI:1760375695
Name:WEBER, LAURA MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:WEBER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MARIE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:420 VICTORY PARK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2484
Mailing Address - Country:US
Mailing Address - Phone:402-489-3802
Mailing Address - Fax:612-725-1091
Practice Address - Street 1:420 VICTORY PARK DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2484
Practice Address - Country:US
Practice Address - Phone:402-489-3802
Practice Address - Fax:612-725-1091
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE58636163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse