Healthcare Provider Details

I. General information

NPI: 1841970019
Provider Name (Legal Business Name): LAURENE LAGANO A-GNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 MCGLOTHLIN RD
CONOWINGO MD
21918-1726
US

IV. Provider business mailing address

127 MCGLOTHLIN RD
CONOWINGO MD
21918-1726
US

V. Phone/Fax

Practice location:
  • Phone: 443-206-8181
  • Fax:
Mailing address:
  • Phone: 443-206-8181
  • Fax: 410-584-5639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR229742
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: