Provider Demographics
NPI:1164977864
Name:OFARRELL, LAURA (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:OFARRELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-5726
Mailing Address - Country:US
Mailing Address - Phone:814-931-4868
Mailing Address - Fax:
Practice Address - Street 1:241 MAPLE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-7006
Practice Address - Country:US
Practice Address - Phone:814-693-1415
Practice Address - Fax:814-693-9880
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016381363LA2200X
PASP024692363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health