Provider Demographics
NPI:1952769572
Name:ESPER, LAURIE (NP-C)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:ESPER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13061 KIMMENS RD SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-9785
Mailing Address - Country:US
Mailing Address - Phone:330-265-7122
Mailing Address - Fax:
Practice Address - Street 1:13061 KIMMENS RD SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-9785
Practice Address - Country:US
Practice Address - Phone:330-265-7122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 18578-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH468971Medicare PIN
OHH468970Medicare PIN