MEDICARE: LAURA MARIE DUNCAN LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN260231L	PA

General Provider Information

NPI Number	:	1174831564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MARIE DUNCAN LPN

Provider Business Mailing Address
First Line	:	2944 ZEPHYR AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15204-1943
Country	:	US
Telephone Number	:	412-458-3161
Fax Number	:	412-458-3161

Provider Business Practice Location Address
First Line	:	2944 ZEPHYR AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15204-1943
Country	:	US
Telephone Number	:	412-458-3161
Fax Number	:	412-458-3161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	09/20/2010

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