Healthcare Provider Details

I. General information

NPI: 1891167607
Provider Name (Legal Business Name): LAURA AUSTEN HARRIS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA AUSTEN BERGER FNP-C

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE # 4200
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-8296
  • Fax: 410-550-4153
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015503
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR248128
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: