NPI 1053390351

Laura Jean Stavrakis, PAC

Practitioner Physician Assistant Clarksburg, WV

Practice location

Address: 399 Emily Dr, Clarksburg, WV 26301-5505
Phone: (304) 624-4315
Fax: (304) 624-4319
Mailing address: 125 N 6th St, Clarksburg, WV 26301-2665

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 01156 (WV)

Other Physician Assistant providers in West Virginia →

Registry record

NPI: 1053390351
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jan 2006
Record last updated: 23 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.