Basic Information
Provider Information
NPI: 1144727652
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SZABO
FirstName: LAURA
MiddleName: ASHTON
NamePrefix: MS.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 111 S FRONT ST
Address2:  
City: HARRISBURG
State: PA
PostalCode: 171012010
CountryCode: US
TelephoneNumber: 7172318772
FaxNumber: 7172318964
Practice Location
Address1: 111 S FRONT ST
Address2:  
City: HARRISBURG
State: PA
PostalCode: 17101
CountryCode: US
TelephoneNumber: 7177823282
FaxNumber: 7172318964
Other Information
ProviderEnumerationDate: 04/11/2018
LastUpdateDate: 02/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN657033PAN Nursing Service ProvidersRegistered Nurse 
367500000XRN657033PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
10349715005PA MEDICAID


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