Healthcare Provider Details

I. General information

NPI: 1871180802
Provider Name (Legal Business Name): NICOLE LARO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EASTOWNE DR
CHAPEL HILL NC
27514-2286
US

IV. Provider business mailing address

11600 CORE AVE
OKLAHOMA CITY OK
73170-3644
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-4462
  • Fax:
Mailing address:
  • Phone: 405-445-8234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLARO-D1XQIC
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: