Provider Demographics
NPI:1699851543
Name:FERRARO, LAURI LOUISE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LAURI
Middle Name:LOUISE
Last Name:FERRARO
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:PO BOX 3925
Mailing Address - Street 2:HORIZON BILLING
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59772-3925
Mailing Address - Country:US
Mailing Address - Phone:406-585-9662
Mailing Address - Fax:406-587-7656
Practice Address - Street 1:300 N WILLSON AVE
Practice Address - Street 2:SAME DAY SURGERY CENTER
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3551
Practice Address - Country:US
Practice Address - Phone:406-586-1956
Practice Address - Fax:406-587-7656
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN 3075367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4305216Medicaid
MT00010881OtherBLUE CROSS/BLUE SHIELD
MT4305216Medicaid