Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0994473 | CO |
NPI | 1013566553 |
---|---|
Provider Name | Elizabeth Laporte |
First Address | Denver, CO 80210-5714 |
Second Address | Wheat Ridge, CO 80033-6027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2019 |
Last Update Date | 07/09/2019 |