Provider Demographics
NPI:1295399939
Name:SCHANBERGER, LAURA CORYN (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CORYN
Last Name:SCHANBERGER
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 1:2 RAINFLOWER PATH UNIT 202
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-8923
Mailing Address - Country:US
Mailing Address - Phone:410-371-3278
Mailing Address - Fax:
Practice Address - Street 1:4924 CAMPBELL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5914
Practice Address - Country:US
Practice Address - Phone:443-442-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR211134363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care