Provider Demographics
NPI:1053698902
Name:KLOPFER, LAURA LEE (STNA)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:KLOPFER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N STATELINE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45390
Mailing Address - Country:US
Mailing Address - Phone:937-899-0045
Mailing Address - Fax:
Practice Address - Street 1:320 NORTH STATELINE STREET
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:OH
Practice Address - Zip Code:45390
Practice Address - Country:US
Practice Address - Phone:937-899-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400711440108374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide