Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | VP006958B | PA |
NPI | 1023028289 |
---|---|
Provider Name | Ms. Melissa Laporte |
First Address | Plains, PA 18705-1509 |
Second Address | Wilkes Barre, PA 18702-7900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 22/06/2020 |