Provider Demographics
NPI:1780677955
Name:SARCONE, LAURA LONG (CNM, ANP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LONG
Last Name:SARCONE
Suffix:
Gender:F
Credentials:CNM, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-1638
Mailing Address - Country:US
Mailing Address - Phone:907-272-4047
Mailing Address - Fax:
Practice Address - Street 1:4320 DIPLOMACY DR
Practice Address - Street 2:SUITE 1800
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5925
Practice Address - Country:US
Practice Address - Phone:907-729-3100
Practice Address - Fax:907-729-3170
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK419363LA2200X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP04193Medicaid
AK042WCHMXEMedicare ID - Type UnspecifiedMEDICARE
AKS31107Medicare UPIN