Provider Demographics
NPI:1689124349
Name:FELTON-ZERAFA, LAURA SUE (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:SUE
Last Name:FELTON-ZERAFA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 EDGEMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-4206
Mailing Address - Country:US
Mailing Address - Phone:269-993-9758
Mailing Address - Fax:
Practice Address - Street 1:404 HAZEN ST STE L3
Practice Address - Street 2:
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-1040
Practice Address - Country:US
Practice Address - Phone:269-657-1595
Practice Address - Fax:269-657-1534
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007992363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant