Provider Demographics
NPI:1679373757
Name:BERRIAN, LAURA WILDER (RN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:WILDER
Last Name:BERRIAN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:WILDER
Other - Last Name:SCHWARTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1419 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-6105
Mailing Address - Country:US
Mailing Address - Phone:717-877-4522
Mailing Address - Fax:
Practice Address - Street 1:1995 TECHNOLOGY PKWY
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-8522
Practice Address - Country:US
Practice Address - Phone:717-791-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN679672163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse