Provider Demographics
NPI:1518199397
Name:LAMOTTE, NICHOLE RENEE (CM)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:RENEE
Last Name:LAMOTTE
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 MARIPOSA BLVD
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-4829
Mailing Address - Country:US
Mailing Address - Phone:307-265-6989
Mailing Address - Fax:
Practice Address - Street 1:1820 MARIPOSA BLVD
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82604-4829
Practice Address - Country:US
Practice Address - Phone:307-265-6989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator