Provider Demographics
NPI:1770846255
Name:BINKLEY, LAURA EASTERLY (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:EASTERLY
Last Name:BINKLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 MARKET STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-746-3535
Mailing Address - Fax:717-337-4249
Practice Address - Street 1:3535 MARKET STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-746-3535
Practice Address - Fax:717-337-4249
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1607764OtherGATEWAY MEDICARE ASSURED
PA2718371OtherHIGHMARK BLUE SHIELD - FREEDOM BLUE
PAP01129193OtherRAILROAD MEDICARE
PA1607764OtherGATEWAY MEDICARE ASSURED
PAP01129193OtherRAILROAD MEDICARE
PAP01161427Medicare PIN