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General NPI Number Information
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NPI Number | 1508715517
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Entity Type | Organization
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Legal Business Name | L AND L MEDICAL LLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 4 1/2 BARTLETT RD
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City | NANTUCKET
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State | MA
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Zip | 02554-4381
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Country | US
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Telephone | 617-326-3817
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Fax |
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Provider Business Mailing Address
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Address Line | 4 1/2 BARTLETT RD
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City | NANTUCKET
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State | MA
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Zip | 02554-4381
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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 | NP
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Name | LAURA VITA KOHTIO-GRAVES
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Credential | NP
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Telephone | 508-524-0730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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