Provider Demographics
NPI:1124322367
Name:ETLING-SHWONEK, LAURA SUSANNE (PNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:SUSANNE
Last Name:ETLING-SHWONEK
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:SUSANNE
Other - Last Name:ETLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:ONE PERKINS SQUARE
Mailing Address - Street 2:AKRON CHILDREN'S HOSPITAL
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308
Mailing Address - Country:US
Mailing Address - Phone:330-543-8452
Mailing Address - Fax:330-543-3761
Practice Address - Street 1:ONE PERKINS SQUARE
Practice Address - Street 2:AKRON CHILDREN'S HOSPITAL
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308
Practice Address - Country:US
Practice Address - Phone:330-543-8452
Practice Address - Fax:330-543-3761
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12085-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner