Provider Demographics
NPI:1033104278
Name:DUNNING, LAURICE S (CNM)
Entity Type:Individual
Prefix:MRS
First Name:LAURICE
Middle Name:S
Last Name:DUNNING
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W HAMILTON ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6337
Mailing Address - Country:US
Mailing Address - Phone:610-435-8130
Mailing Address - Fax:610-435-4515
Practice Address - Street 1:2200 W HAMILTON ST
Practice Address - Street 2:SUITE 212
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6337
Practice Address - Country:US
Practice Address - Phone:610-435-8130
Practice Address - Fax:610-435-4515
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008416-L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016336530007Medicaid
PA001607QHLMedicare ID - Type Unspecified
PA0016336530007Medicaid