Provider Demographics
NPI:1770236473
Name:KOLTERMANN, LAURA BRANDI
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BRANDI
Last Name:KOLTERMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 ELLIS RD
Mailing Address - Street 2:
Mailing Address - City:MONCURE
Mailing Address - State:NC
Mailing Address - Zip Code:27559-9539
Mailing Address - Country:US
Mailing Address - Phone:919-721-8967
Mailing Address - Fax:
Practice Address - Street 1:248 ELLIS RD
Practice Address - Street 2:
Practice Address - City:MONCURE
Practice Address - State:NC
Practice Address - Zip Code:27559-9539
Practice Address - Country:US
Practice Address - Phone:919-721-8967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider