Provider Demographics
NPI:1952335952
Name:STERNER, LAURA SORENSON (RN/CRNA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:SORENSON
Last Name:STERNER
Suffix:
Gender:F
Credentials:RN/CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 TRANQUIL LN
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-9017
Mailing Address - Country:US
Mailing Address - Phone:541-677-9473
Mailing Address - Fax:541-677-9740
Practice Address - Street 1:2435 NW KLINE ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-1690
Practice Address - Country:US
Practice Address - Phone:541-672-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR083043019367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR083043019OtherRN/CRNA LICENSE #
OR210268Medicaid
OR430061714OtherRAILROAD MEDICARE
OR046628OtherAANA
OR083043019OtherRN/CRNA LICENSE #
OR210268Medicaid