Provider Demographics
NPI:1285012526
Name:HERBENER, LAURA (CRNP, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:HERBENER
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19192-0003
Mailing Address - Country:US
Mailing Address - Phone:215-761-3939
Mailing Address - Fax:215-761-5602
Practice Address - Street 1:1601 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19192-0003
Practice Address - Country:US
Practice Address - Phone:215-761-3939
Practice Address - Fax:215-761-5602
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030910363LF0000X
PASP015107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily