Provider Demographics
NPI:1639221633
Name:BATEMAN, LAURA A (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MORROW WAY
Mailing Address - Street 2:STUDENT HEALTH CENTER
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-1383
Mailing Address - Country:US
Mailing Address - Phone:724-738-2052
Mailing Address - Fax:724-738-2078
Practice Address - Street 1:1 MORROW WAY
Practice Address - Street 2:STUDENT HEALTH CENTER
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1383
Practice Address - Country:US
Practice Address - Phone:724-738-2052
Practice Address - Fax:724-738-2078
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP000972B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily