Provider Demographics
NPI:1801469002
Name:LAPORTE, RENEE K (RN)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:K
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 ABSCOTT ST
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-2933
Mailing Address - Country:US
Mailing Address - Phone:941-875-9905
Mailing Address - Fax:
Practice Address - Street 1:1420 ABSCOTT ST
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-2933
Practice Address - Country:US
Practice Address - Phone:941-875-9905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2700872163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty