Provider Demographics
NPI:1609866813
Name:STEIN, LAURIE A (CRNA)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:STEIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 NAUTICA MILE DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2469
Mailing Address - Country:US
Mailing Address - Phone:407-259-9783
Mailing Address - Fax:
Practice Address - Street 1:1600 N GRAND AVE
Practice Address - Street 2:SUITE 440
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2700
Practice Address - Country:US
Practice Address - Phone:719-543-3500
Practice Address - Fax:719-543-3504
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-133333367500000X
TX815764367500000X
NC105988367500000X
OH379104367500000X
ME61538367500000X
FL2589902367500000X
FLARNP2589902367500000X
NMCRNA-01312367500000X
CO201762367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered