MEDICARE: DR. LAURA ANNE ESTUPINAN-KANE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	03853	MD
2	103TC0700X	Clinical Psychologist	03853	MD

General Provider Information

NPI Number	:	1396952727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA ANNE ESTUPINAN-KANE PH.D.

Provider Business Mailing Address
First Line	:	132 WHITEMARSH CT
Second Line	:
City	:	MURRELLS INLET
State	:	SC
Zip	:	29576-7980
Country	:	US
Telephone Number	:	443-622-3127
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 WEST HILL BLVD
Second Line	:	JOINT BASE CHARLESTON
City	:	CHARLESTON
State	:	SC
Zip	:	29404
Country	:	US
Telephone Number	:	843-963-6548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	09/11/2025

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