Provider Demographics
NPI:1225572712
Name:DUNN-O'FARRELL, LAURAROSE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURAROSE
Middle Name:
Last Name:DUNN-O'FARRELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAURAROSE
Other - Middle Name:
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5024 CAMPBELL BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5974
Mailing Address - Country:US
Mailing Address - Phone:410-931-9280
Mailing Address - Fax:410-931-6694
Practice Address - Street 1:5024 CAMPBELL BLVD STE H
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5974
Practice Address - Country:US
Practice Address - Phone:410-931-9280
Practice Address - Fax:410-931-6694
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0006334363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant