Provider Demographics
NPI:1306480348
Name:KRISHER, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:KRISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TURBOTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17772-8824
Mailing Address - Country:US
Mailing Address - Phone:570-428-5106
Mailing Address - Fax:
Practice Address - Street 1:244 MAIN ST
Practice Address - Street 2:
Practice Address - City:TURBOTVILLE
Practice Address - State:PA
Practice Address - Zip Code:17772-8824
Practice Address - Country:US
Practice Address - Phone:570-428-5106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN290929164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse