Healthcare Provider Details

I. General information

NPI: 1043772635
Provider Name (Legal Business Name): LAUREN MASTROMARINO ZERBE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BERKSHIRE CT
WYOMISSING PA
19610-1224
US

IV. Provider business mailing address

1218 GIRARD AVE
WYOMISSING PA
19610-2418
US

V. Phone/Fax

Practice location:
  • Phone: 610-374-7400
  • Fax:
Mailing address:
  • Phone: 484-794-0513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP020211
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN664471
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: