Provider Demographics
NPI:1700483831
Name:FERKATCH, LAUREN JANE (CRNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JANE
Last Name:FERKATCH
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 1:196 LAVENDER LN
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3654
Mailing Address - Country:US
Mailing Address - Phone:814-221-1426
Mailing Address - Fax:
Practice Address - Street 1:62 GREENBRIAR DR STE 1
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-8206
Practice Address - Country:US
Practice Address - Phone:724-845-7765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily