Provider Demographics
NPI:1619942877
Name:PALMER, LAURA ANN (CRNA)
Entity Type:Individual
Prefix:PROF
First Name:LAURA
Middle Name:ANN
Last Name:PALMER
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 1:1300 OXFORD DR
Mailing Address - Street 2:UPMC SOUTH SURGERY CENTER
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1896
Mailing Address - Country:US
Mailing Address - Phone:412-851-8600
Mailing Address - Fax:
Practice Address - Street 1:1300 OXFORD DR
Practice Address - Street 2:UPMC SOUTH SURGERY CENTER
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1896
Practice Address - Country:US
Practice Address - Phone:412-851-8600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN192571L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA015839FEVMedicare ID - Type Unspecified
PAS62393Medicare UPIN