Provider Demographics
NPI:1871726620
Name:MAGRANE, LAURA R (PA-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:MAGRANE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:R
Other - Last Name:PESTKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-384-7070
Mailing Address - Fax:319-356-4705
Practice Address - Street 1:2701 PRAIRIE MEADOW DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-8001
Practice Address - Country:US
Practice Address - Phone:319-384-7070
Practice Address - Fax:319-356-4705
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002027363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI09230276Medicare PIN