Healthcare Provider Details

I. General information

NPI: 1497665954
Provider Name (Legal Business Name): LAURA LEE EAGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 N CENTER AVE
SOMERSET PA
15501-1026
US

IV. Provider business mailing address

126 E GARRETT ST
SOMERSET PA
15501-2542
US

V. Phone/Fax

Practice location:
  • Phone: 814-442-9959
  • Fax:
Mailing address:
  • Phone: 814-215-7151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP036854
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: