Provider Demographics
NPI:1083015549
Name:EDGERTON, LAURA YORK (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:YORK
Last Name:EDGERTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 RESERVATION DR
Mailing Address - Street 2:
Mailing Address - City:SPINDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28160-1566
Mailing Address - Country:US
Mailing Address - Phone:828-287-0200
Mailing Address - Fax:
Practice Address - Street 1:144 RESERVATION DR
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-1566
Practice Address - Country:US
Practice Address - Phone:828-287-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06838363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant