Provider Demographics
NPI:1801388350
Name:LAMOTHE, ELIZABETH (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LAMOTHE
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 1:2160 CAPITAL CIR NE STE 200
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4391
Mailing Address - Country:US
Mailing Address - Phone:850-558-1260
Mailing Address - Fax:850-558-1298
Practice Address - Street 1:2160 CAPITAL CIR NE STE 200
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4391
Practice Address - Country:US
Practice Address - Phone:850-558-1260
Practice Address - Fax:850-558-1298
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9257965363L00000X
FLAPRN9257965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner