Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 0024182720 | VA |
NPI | 1083385967 |
---|---|
Provider Name | Laura Brott |
First Address | Alexandria, VA 22304-1306 |
Second Address | Alexandria, VA 22304-1306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2021 |
Last Update Date | 14/10/2021 |