Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Laura Dyal

Individual provider Family Nurse Practitioner · NPI 1295120004

Laura Dyal is a Nurse Practitioner in Marietta, Georgia. Qualified in 2014, 12 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
12
Licensed in
GA
In the registry since
2015
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Practice location Address checks out

631 Campbell Hill St NW Ste 100
Marietta, GA 30060-1390
Phone: (770) 422-0444
Fax: (770) 422-4412
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN162458 (GA)

Record details

NPI number1295120004
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 30, 2015
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Marietta