Healthcare Provider Details

I. General information

NPI: 1134038946
Provider Name (Legal Business Name): KESHIA LAPORTE FAMILY HEALTH NURSE PRACTITIONER,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22615 139TH AVE
SPRINGFIELD GARDENS NY
11413-2722
US

IV. Provider business mailing address

22615 139TH AVE
SPRINGFIELD GARDENS NY
11413-2722
US

V. Phone/Fax

Practice location:
  • Phone: 646-842-8405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KESHIA LAPORTE
Title or Position: OWNER
Credential: DNP-BC
Phone: 646-842-8405