Healthcare Provider Details

I. General information

NPI: 1497717151
Provider Name (Legal Business Name): KELLY A LAINO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

IV. Provider business mailing address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-8300
  • Fax: 717-544-8265
Mailing address:
  • Phone: 717-544-8300
  • Fax: 717-544-8265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberTP003966U
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: