Provider Demographics
NPI:1659941763
Name:PASTRANA GUTIERREZ, LAURA MARCELA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MARCELA
Last Name:PASTRANA GUTIERREZ
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:6117 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4758
Mailing Address - Country:US
Mailing Address - Phone:717-715-4101
Mailing Address - Fax:
Practice Address - Street 1:196 THOMAS JOHNSON DR STE 120
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4521
Practice Address - Country:US
Practice Address - Phone:240-566-3130
Practice Address - Fax:240-566-3131
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-09-17
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant