Individual provider Active NPI

Laura Balmer, CRNP

  • Adult Health Nurse Practitioner
  • Wellsboro, PA
National Provider Identifier
1497723894
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP013789 Issued in PA
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

Updated by the provider on May 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
02301004MedicaidNY

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

LicenseStateTypeSpecialty
303540-1NYMDAdult 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.

Verify at the official NPI Registry.