Provider Demographics
NPI:1437789211
Name:MYERS, LAURA DANIELLE (CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DANIELLE
Last Name:MYERS
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 BLACKWELL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3783
Mailing Address - Country:US
Mailing Address - Phone:301-340-1188
Mailing Address - Fax:855-716-1603
Practice Address - Street 1:945 CHESTERBROOK BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERBROOK
Practice Address - State:PA
Practice Address - Zip Code:19087-5614
Practice Address - Country:US
Practice Address - Phone:610-981-6000
Practice Address - Fax:855-437-5785
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021411363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty