Provider Demographics
NPI:1124405139
Name:DUCOTE, LAURA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:DUCOTE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:DRURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:257 HIGH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-4016
Mailing Address - Country:US
Mailing Address - Phone:423-310-3868
Mailing Address - Fax:
Practice Address - Street 1:2970 PELHAM PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1799
Practice Address - Country:US
Practice Address - Phone:205-621-6411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1131831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily