Healthcare Provider Details

I. General information

NPI: 1770975815
Provider Name (Legal Business Name): ELISA SPOTORNO LAFRANCE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 DRINKWATER RD
BAY ST LOUIS MS
39520-1658
US

IV. Provider business mailing address

149 DRINKWATER RD
BAY ST LOUIS MS
39520-1658
US

V. Phone/Fax

Practice location:
  • Phone: 228-220-5200
  • Fax:
Mailing address:
  • Phone: 228-220-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR874917
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP08192
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: