Provider Demographics
NPI:1487604716
Name:LETCHER, LAWRENCE D (CRNA)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:D
Last Name:LETCHER
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:4135 BOARDMAN CANFIELD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9803
Mailing Address - Country:US
Mailing Address - Phone:330-286-5330
Mailing Address - Fax:330-286-5396
Practice Address - Street 1:3893 E MARKET ST
Practice Address - Street 2:STE 2
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4706
Practice Address - Country:US
Practice Address - Phone:330-856-1272
Practice Address - Fax:330-856-2960
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-01-17
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Provider Licenses
StateLicense IDTaxonomies
OHRN238083367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2535948Medicaid
OH8234601Medicare PIN