Healthcare Provider Details

I. General information

NPI: 1699318493
Provider Name (Legal Business Name): LAURA F PEDONE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LAURA ERHARDT

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 BELMONT AVE STE 105A
SALISBURY MD
21804-4584
US

IV. Provider business mailing address

506 SAINT LOUIS AVE UNIT 3
OCEAN CITY MD
21842-4097
US

V. Phone/Fax

Practice location:
  • Phone: 443-978-8564
  • Fax:
Mailing address:
  • Phone: 443-617-4084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR201005
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR201005
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: