Healthcare Provider Details

I. General information

NPI: 1649786674
Provider Name (Legal Business Name): LAURA PATRICIA STONE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

407 S MELVILLE AVE APT 7
TAMPA FL
33606-2043
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-7100
  • Fax:
Mailing address:
  • Phone: 360-904-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9355684
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: