Provider Demographics
NPI:1649450875
Name:BISCOTTE, LAURA C (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:BISCOTTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MARKET CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3261
Mailing Address - Country:US
Mailing Address - Phone:540-992-1251
Mailing Address - Fax:540-992-5958
Practice Address - Street 1:60 MARKET CENTER WAY
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3261
Practice Address - Country:US
Practice Address - Phone:540-992-1251
Practice Address - Fax:540-992-5958
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1649450875Medicaid