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General NPI Number Information
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NPI Number | 1083385967
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Entity Type | Individual
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Provider Name | LAURA BROTT
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Gender | Female
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 3620 JOSEPH SIEWICK DR STE 307
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City | FAIRFAX
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State | VA
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Zip | 22033-1760
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Country | US
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Telephone | 571-419-5645
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Fax | 571-665-6428
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Provider Business Mailing Address
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Address Line | 2090 PALM BEACH LAKES BLVD STE 700
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-6508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024182720
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License Number State | VA
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