Provider Demographics
NPI:1689406589
Name:RASOR, LAURA J (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:RASOR
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 COUNTY ROAD 801B
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-8122
Mailing Address - Country:US
Mailing Address - Phone:817-475-5875
Mailing Address - Fax:
Practice Address - Street 1:2316 COUNTY ROAD 801B
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-8122
Practice Address - Country:US
Practice Address - Phone:817-475-5875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX741921363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health