Provider Demographics
NPI:1508131293
Name:YOCUM, LAURIE (CRNA)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:YOCUM
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:SANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-861-0854
Practice Address - Street 1:1503 N CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2302
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-861-0854
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN550527367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered