Provider Demographics
NPI:1073357356
Name:ESPARRA, LAUREL (FNP BC)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:ESPARRA
Suffix:
Gender:F
Credentials:FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 6TH ST
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1062
Mailing Address - Country:US
Mailing Address - Phone:330-207-8888
Mailing Address - Fax:
Practice Address - Street 1:986 TIBBETTS WICK RD
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-1138
Practice Address - Country:US
Practice Address - Phone:330-736-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP0033100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily