Provider Demographics
NPI:1245264860
Name:LAUDISE, MARGARET JOYCE (CRNP MSN)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:JOYCE
Last Name:LAUDISE
Suffix:
Gender:F
Credentials:CRNP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:414 EAST WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095
Mailing Address - Country:US
Mailing Address - Phone:215-884-2274
Mailing Address - Fax:215-884-6721
Practice Address - Street 1:414 EAST WAVERLY RD
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095
Practice Address - Country:US
Practice Address - Phone:215-884-2274
Practice Address - Fax:215-884-6721
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP001607H363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA021760Medicare ID - Type Unspecified