Provider Demographics
NPI:1811626971
Name:DUFORT, LAURE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LAURE
Middle Name:
Last Name:DUFORT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4980 TAMIAMI TRL N STE 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2849
Mailing Address - Country:US
Mailing Address - Phone:239-682-4900
Mailing Address - Fax:
Practice Address - Street 1:4980 TAMIAMI TRL N STE 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2849
Practice Address - Country:US
Practice Address - Phone:239-682-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021168363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty