Provider Demographics
NPI:1396272282
Name:WETZEL, LAURA AMBER (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:AMBER
Last Name:WETZEL
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:AMBER
Other - Last Name:WETZEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5100 LOCUST VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-2448
Mailing Address - Country:US
Mailing Address - Phone:610-282-2270
Mailing Address - Fax:
Practice Address - Street 1:127 S 5TH ST STE 170
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1682
Practice Address - Country:US
Practice Address - Phone:267-347-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016469363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health