Provider Demographics
NPI:1801264023
Name:LERNER, LAURA BETH (CPNP-AC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:LERNER
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-AC
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC CRITICAL CARE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-3360
Mailing Address - Fax:414-266-3563
Practice Address - Street 1:7777 FOREST LN STE C300J
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2604
Practice Address - Country:US
Practice Address - Phone:972-566-7730
Practice Address - Fax:469-484-0378
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225075-30163WP0200X, 363LP0222X
TX827557163WP0200X
TXAP145172363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No163WP0200XNursing Service ProvidersRegistered NursePediatrics