Provider Demographics
NPI:1578790036
Name:BURER, LARA ASHLEY (CPNP)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:ASHLEY
Last Name:BURER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 CRABAPPLE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2489
Mailing Address - Country:US
Mailing Address - Phone:770-518-9277
Mailing Address - Fax:770-518-8718
Practice Address - Street 1:11050 CRABAPPLE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2489
Practice Address - Country:US
Practice Address - Phone:770-518-9277
Practice Address - Fax:770-518-8718
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN191841 NP364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics