MEDICARE: MRS. KAREN LAUREL - FORBES BLEIER CSA

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	246ZS0410X	Surgical Technologist	2371	VA

General Provider Information

NPI Number	:	1871565440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN LAUREL - FORBES BLEIER CSA

Provider Business Mailing Address
First Line	:	3100 MONET DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-5510
Country	:	US
Telephone Number	:	757-478-4944
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3002
Country	:	US
Telephone Number	:	757-395-8191
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/08/2007

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