Provider Demographics
NPI:1275787681
Name:TALAKKOTTUR, LAURA MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MARIE
Last Name:TALAKKOTTUR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W PLATT ST
Mailing Address - Street 2:#215
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2292
Mailing Address - Country:US
Mailing Address - Phone:813-227-8855
Mailing Address - Fax:
Practice Address - Street 1:301 W PLATT ST
Practice Address - Street 2:#215
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2292
Practice Address - Country:US
Practice Address - Phone:813-227-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9276542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily