Provider Demographics
NPI:1699318493
Name:PEDONE, LAURA F (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:F
Last Name:PEDONE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:ERHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:506 SAINT LOUIS AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-4097
Mailing Address - Country:US
Mailing Address - Phone:443-617-4084
Mailing Address - Fax:
Practice Address - Street 1:1324 BELMONT AVE STE 105A
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4584
Practice Address - Country:US
Practice Address - Phone:443-978-8564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201005363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care