Provider Demographics
NPI:1003850728
Name:PIROTTE, LARRY JOSEPH (CRNA)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:JOSEPH
Last Name:PIROTTE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 N 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-6006
Mailing Address - Country:US
Mailing Address - Phone:319-354-5981
Mailing Address - Fax:
Practice Address - Street 1:601 HW 6 W
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246
Practice Address - Country:US
Practice Address - Phone:319-338-0581
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD059601367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered