Individual provider Active NPI

Laurette Flannery, ANP-BC

  • Nurse Practitioner
  • Lebanon, PA
National Provider Identifier
1306208913
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP014941 Issued in PA
Practice address
1700 S Lincoln Ave
Lebanon, PA 17042-7597
Phone
(717) 272-6621
Fax
(717) 228-6036
NPI assigned
Mar 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP014941 PA Primary

Addresses

Primary practice location

1700 S Lincoln Ave
Lebanon, PA 17042-7597

Mailing address

1700 S Lincoln Ave
Lebanon, PA 17042-7597
Phone (717) 272-6621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031004075 PA Order and Referring Only - Nurse Practitioner 3779872023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP014941PAMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1306208913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427597",
            "telephone_number": "717-272-6621",
            "fax_number": "717-228-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427597",
            "telephone_number": "717-272-6621",
            "fax_number": "717-228-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "LAURETTE",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP014941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.