Active NPI
Laura Balmer, CRNP
- Adult Health Nurse Practitioner
- Wellsboro, PA
National Provider Identifier
1497723894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- SP013789
- Practice address
- 15 Meade St
Suite L3
Wellsboro, PA 16901-1813 - Phone
- (570) 723-2855
- Fax
- (570) 723-2877
- NPI assigned
- Mar 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 303540-1 | NY | |
| Adult Health Nurse Practitioner | 363LA2200X | SP013789 | PA | Primary |
Addresses
Primary practice location
15 Meade St
Suite L3
Wellsboro, PA 16901-1813
Mailing address
1201 Grampian Blvd
Suite 1K
Williamsport, PA 17701-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02301004 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303540-1 | NY | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1497723894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 GRAMPIAN BLVD",
"address_2": "SUITE 1K",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 MEADE ST",
"address_2": "SUITE L3",
"city": "WELLSBORO",
"state": "PA",
"postal_code": "169011813",
"telephone_number": "570-723-2855",
"fax_number": "570-723-2877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALMER",
"first_name": "LAURA",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-10",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "303540-1",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "SP013789",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02301004",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wellsboro, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.