Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | TP003966U | PA |
NPI | 1497717151 |
---|---|
Provider Name | Kelly A Laino |
First Address | Lancaster, PA 17603-2964 |
Second Address | Lancaster, PA 17603-2964 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 18/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S30977 | (02) | PA |