Provider Demographics
NPI:1831114230
Name:BURKHART, LAURA A (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:BURKHART
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 1:2550 MOSSIDE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3531
Mailing Address - Country:US
Mailing Address - Phone:412-373-6666
Mailing Address - Fax:412-373-4595
Practice Address - Street 1:6024 HOOVER RD
Practice Address - Street 2:SUITE G
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8133
Practice Address - Country:US
Practice Address - Phone:614-324-9090
Practice Address - Fax:614-224-3044
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06566363L00000X
PASP010494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP44658Medicare UPIN
OHNP09161Medicare ID - Type Unspecified