Provider Demographics
NPI:1538687462
Name:LAROSE, LAURA BETH BITTNER (RN-BC, MSN, OCN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH BITTNER
Last Name:LAROSE
Suffix:
Gender:F
Credentials:RN-BC, MSN, OCN
Other - Prefix:
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Mailing Address - Street 1:1029 2ND ST APT 205
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-3616
Mailing Address - Country:US
Mailing Address - Phone:860-328-0426
Mailing Address - Fax:
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 560W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2182
Practice Address - Country:US
Practice Address - Phone:310-453-5654
Practice Address - Fax:310-453-6885
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA812892163WX0200X
CA95006980363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0200XNursing Service ProvidersRegistered NurseOncology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care