Provider Demographics
NPI:1700273133
Name:KURALT, LAURIE (APRN, AGACNP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:KURALT
Suffix:
Gender:F
Credentials:APRN, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-7601
Mailing Address - Country:US
Mailing Address - Phone:802-257-8394
Mailing Address - Fax:802-257-8309
Practice Address - Street 1:17 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7601
Practice Address - Country:US
Practice Address - Phone:802-257-8394
Practice Address - Fax:802-257-8309
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0111230363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care